Provider Demographics
NPI:1588427041
Name:REYES, FABIOLA (BCHHP)
Entity type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:BCHHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W GREEN ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-5252
Mailing Address - Country:US
Mailing Address - Phone:716-465-8615
Mailing Address - Fax:
Practice Address - Street 1:520 W GREEN ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5252
Practice Address - Country:US
Practice Address - Phone:716-570-3581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach