Healthcare Provider Details

I. General information

NPI: 1154090215
Provider Name (Legal Business Name): REED INTEGRATIVE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 ATLANTIC AVE FL 3
ATLANTIC CITY NJ
08401-6804
US

IV. Provider business mailing address

174 NASSAU ST # 321
PRINCETON NJ
08542-7005
US

V. Phone/Fax

Practice location:
  • Phone: 702-443-8038
  • Fax:
Mailing address:
  • Phone: 702-443-8038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name: RITA VASHTI LEWIS
Title or Position: PRINCIPAL
Credential:
Phone: 702-443-8038