Provider Demographics
NPI:1730568098
Name:REICH, BLYTHE VALENCIA (M ED)
Entity type:Individual
Prefix:MRS
First Name:BLYTHE
Middle Name:VALENCIA
Last Name:REICH
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 NEEDMORE RD
Mailing Address - Street 2:UNIT 22
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6275
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:238 VILLAGE SQ
Practice Address - Street 2:SUITE 300
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-7178
Practice Address - Country:US
Practice Address - Phone:409-880-5714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other