Provider Demographics
NPI:1487544805
Name:DELGRANDE, REESE D (BA)
Entity type:Individual
Prefix:MR
First Name:REESE
Middle Name:D
Last Name:DELGRANDE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22809 E COUNTRY VISTA DR APT 320
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7573
Mailing Address - Country:US
Mailing Address - Phone:908-546-2767
Mailing Address - Fax:
Practice Address - Street 1:1616 E SELTICE WAY
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-7007
Practice Address - Country:US
Practice Address - Phone:209-719-7158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician