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General NPI Number Information
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NPI Number | 1215806880
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Entity Type | Individual
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Provider Name | MISS RONNA REAVES
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Gender | Female
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 517 TOWN AND COUNTRY DR
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City | BERNIE
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State | MO
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Zip | 63822-9492
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Country | US
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Telephone | 573-281-8280
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Fax |
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Provider Business Mailing Address
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Address Line | 517 TOWN AND COUNTRY DR
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City | BERNIE
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State | MO
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Zip | 63822-9492
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 669464
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License Number State | MO
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