Healthcare Provider Details

I. General information

NPI: 1609575315
Provider Name (Legal Business Name): MCKENNA CECILIA REED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BROADWAY
NEW YORK NY
10004-1607
US

IV. Provider business mailing address

1875 ATLANTIC AVE APT 4O
BROOKLYN NY
11233-5355
US

V. Phone/Fax

Practice location:
  • Phone: 917-305-7766
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: