Provider Demographics
NPI:1750710455
Name:REISER, MATTHEW (PHD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:REISER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 W 150 S
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-5503
Mailing Address - Country:US
Mailing Address - Phone:801-870-9052
Mailing Address - Fax:435-865-8078
Practice Address - Street 1:351 W UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2415
Practice Address - Country:US
Practice Address - Phone:801-870-9052
Practice Address - Fax:435-865-8078
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5184406-2501103TC1900X
UT103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling