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Individual

DR. MAUREEN LYONS REARDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2500 REGENCY PARKWAY, CARY, NC 27518
(919) 800-1174
(919) 400-4535
Mailing address
13200 STRICKLAND RD., SUITE 114-331, RALEIGH, NC 27613
(919) 800-1174
(919) 400-4535

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3149
NC
103TF0200X
Forensic Psychologist
3149
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1558810580
PTAN TYPE II
NC
01
19K0B
BCBS NC
NC
Enumeration date
07/05/2016
Last updated
07/21/2022
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