Provider Demographics
NPI:1063455459
Name:REESE, SUSAN LINDA (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LINDA
Last Name:REESE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 E FORT LOWELL RD
Mailing Address - Street 2:BLDG. B
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1518
Mailing Address - Country:US
Mailing Address - Phone:520-742-3235
Mailing Address - Fax:520-323-8765
Practice Address - Street 1:2828 E FORT LOWELL RD
Practice Address - Street 2:BLDG. B
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1518
Practice Address - Country:US
Practice Address - Phone:520-742-3235
Practice Address - Fax:520-323-8765
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ849103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical