Provider Demographics
NPI:1366953499
Name:REECE, KRIS (REV, PHD)
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:REECE
Suffix:
Gender:F
Credentials:REV, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 MOUNTAIN BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-6269
Mailing Address - Country:US
Mailing Address - Phone:908-388-1240
Mailing Address - Fax:
Practice Address - Street 1:776 MOUNTAIN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-6269
Practice Address - Country:US
Practice Address - Phone:908-388-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16657101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral