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General NPI Number Information
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NPI Number | 1487070215
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Entity Type | Individual
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Provider Name | ALICIA REEDY
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Gender | Female
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 10273 YELLOW CIRCLE DR
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City | MINNETONKA
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State | MN
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Zip | 55343-9144
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Country | US
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Telephone | 952-223-2506
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Fax |
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Provider Business Mailing Address
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Address Line | 6833 PENN AVE S
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City | RICHFIELD
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State | MN
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Zip | 55423-2010
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Country | US
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Telephone | 507-398-7082
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 9925
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License Number State | MN
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