Basic Information
| Provider Information | |||||||||
| NPI: | 1568509388 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REAMS | ||||||||
| FirstName: | TERRY | ||||||||
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| Credential: | PSY D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 CECILIA SMITH MILL RD | ||||||||
| Address2: | |||||||||
| City: | CECILIA | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427249654 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 107 CRANES ROOST CT | ||||||||
| Address2: | |||||||||
| City: | ELIZABETHTOWN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427013650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707652605 | ||||||||
| FaxNumber: | 2702348572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | KY-0890 | KY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.