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NPI Code Detail

MEDICARE: OLIVIA R REED

MEDICARE: OLIVIA R REED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1023635729
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA R REED
Provider Business Mailing Address
First Line : 343 FOUNTAINS PKWY UNIT 201
Second Line :
City : FAIRVIEW HEIGHTS
State : IL
Zip : 62208-2170
Country : US
Telephone Number : 618-515-1441
Fax Number : 618-551-4711
Provider Business Practice Location Address
First Line : 343 FOUNTAINS PKWY UNIT 201
Second Line :
City : FAIRVIEW HEIGHTS
State : IL
Zip : 62208-2170
Country : US
Telephone Number : 618-515-1441
Fax Number : 618-551-4711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2020
Last Update Date : 05/09/2024

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Directions to “ OLIVIA R REED ” Practice Location

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