Individual provider · Type 1 NPI
Earnest Russell Reaves, LCPC
Professional Counselor · Edgewood, MD
NPI number
1164936738
Active
Practice location
3109 Ebbtide Dr
Edgewood, MD 21040-2920
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LC8273 (MD) |
Professional Counselor: Definition to come...
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About NPI 1164936738
Earnest Russell Reaves, LCPC's National Provider Identifier is 1164936738, issued on Nov 18, 2017. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Edgewood, MD. The record was last updated on Nov 18, 2017.