Individual
MICHAEL OWEN REED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
220 W COLFAX AVE, STE 400, SOUTH BEND, IN 46601-1635
(574) 862-4511
Mailing address
4860 ROBB ST, SUITE 201, WHEAT RIDGE, CO 80033-2184
(303) 278-7418
(888) 341-5050
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20041292A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11629486
CAQH PIN
IN
05
—
200262580
—
IN
01
—
20041292A
PROFESSIONAL LICENSE
IN
Enumeration date
11/28/2006
Last updated
03/15/2019
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