Healthcare Provider Details

I. General information

NPI: 1699611087
Provider Name (Legal Business Name): ELIZABETH VIRGINIA REED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 SELBY AVENUE
SAINT PAUL MN
55104-6421
US

IV. Provider business mailing address

1216 SELBY AVENUE
SAINT PAUL MN
55104-6421
US

V. Phone/Fax

Practice location:
  • Phone: 651-698-1729
  • Fax: 855-611-8594
Mailing address:
  • Phone: 651-698-1729
  • Fax: 855-611-8594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number108080
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: