Provider Demographics
NPI:1174710073
Name:REICH, DEBBIE L (MFT)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:L
Last Name:REICH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-3036
Mailing Address - Country:US
Mailing Address - Phone:951-323-5739
Mailing Address - Fax:
Practice Address - Street 1:620 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-3036
Practice Address - Country:US
Practice Address - Phone:951-323-5739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist