Healthcare Provider Details

I. General information

NPI: 1265345797
Provider Name (Legal Business Name): ZACHARY REID CF SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 NW 18TH ST #100
CLIVE IA
50235
US

IV. Provider business mailing address

1245 SE UNIVERSITY AVE APT 203
WAUKEE IA
50263-8739
US

V. Phone/Fax

Practice location:
  • Phone: 888-228-8476
  • Fax:
Mailing address:
  • Phone: 515-421-2995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number140903
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: