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Individual

DR. NOAH M REAVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCP

Contact information

Practice address
10350 E DAKOTA AVE, STE B, DENVER, CO 80247-1314
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1222
CO
163WP0808X
Psychiatric/Mental Health Registered Nurse
1222
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004137
KAISER-COMMERCIAL NUMBER
05
07012222
CO
Enumeration date
02/16/2007
Last updated
06/23/2021
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