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Individual

DIOSSANTA REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
1161 PENN AVE # 1W, WYOMISSING, PA 19610-2076
(484) 258-9215
Mailing address
1161 PENN AVE # 1W, WYOMISSING, PA 19610-2076
(484) 258-9215

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
106H00000X
Marriage & Family Therapist
MFT001357
PA
106H00000X
Marriage & Family Therapist
Primary
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1659930394
PA
Enumeration date
06/06/2019
Last updated
08/25/2022
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