Healthcare Provider Details

I. General information

NPI: 1316801434
Provider Name (Legal Business Name): ILAYSHA REED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 S WACO STE 35
WICHITA KS
67203
US

IV. Provider business mailing address

3106 W MAY ST
WICHITA KS
67213-1539
US

V. Phone/Fax

Practice location:
  • Phone: 316-202-8775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13982-T
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: