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NPI 1891670113

NPI 1891670113 : KEISHLA MARIE REYES : BAYAMON, PR

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General NPI Number Information
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    NPI Number           |    1891670113
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    Entity Type          |    Individual 
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    Provider Name        |    KEISHLA MARIE REYES
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/06/2025
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    Last Update Date     |    08/06/2025
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Provider Practice Location Address
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    Address Line         |    2U5 AVE LAUREL 
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    City                 |    BAYAMON
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    State                |    PR
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    Zip                  |    00956-3374
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    Country              |    US
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    Telephone            |    787-233-2747
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    HC 6 BOX 6812 
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    City                 |    GUAYNABO
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    State                |    PR
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    Zip                  |    00971-9567
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    Country              |    US
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    Telephone            |    787-616-9071
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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        |    2355S0801X
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    Taxonomy Name        |    Speech-Language Assistant
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    License Number       |    4001
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    License Number State |    PR
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