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General NPI Number Information
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NPI Number | 1316141229
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Entity Type | Individual
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Provider Name | NITA REAGON REED O.T.R.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 901 PENNSYLVANIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-2226
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Country | US
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Telephone | 817-348-9711
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Fax | 817-348-9809
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Provider Business Mailing Address
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Address Line | 2800 BILGLADE RD
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City | FORT WORTH
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State | TX
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Zip | 76133-1616
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Country | US
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Telephone | 817-886-8976
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Fax | 817-923-1263
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 104311
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License Number State | TX
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