Healthcare Provider Details

I. General information

NPI: 1871403717
Provider Name (Legal Business Name): SHAYNA REID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 SW 32ND ST
MOORE OK
73160-7555
US

IV. Provider business mailing address

416 SW 32ND ST
MOORE OK
73160-7555
US

V. Phone/Fax

Practice location:
  • Phone: 405-953-7208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: