MEDICARE: GERVIS REED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1699229310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERVIS REED

Provider Business Mailing Address
First Line	:	7606 WILLOW ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-4052
Country	:	US
Telephone Number	:	504-571-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	4219 MAGNOLIA ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70115-6207
Country	:	US
Telephone Number	:	504-899-4461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2016
Last Update Date	:	08/10/2016

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Directions to “ GERVIS REED ” Practice Location

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