Healthcare Provider Details

I. General information

NPI: 1750047163
Provider Name (Legal Business Name): JESSICA ANNETTE REED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15044 S BLACKBOB RD
OLATHE KS
66062-2663
US

IV. Provider business mailing address

15044 S BLACKBOB RD
OLATHE KS
66062-2663
US

V. Phone/Fax

Practice location:
  • Phone: 913-449-9696
  • Fax:
Mailing address:
  • Phone: 913-449-9696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA183
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5828
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: