MEDICARE: JACOB PARAS 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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1043591696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB PARAS REED

Provider Business Mailing Address
First Line	:	2445 FIRE MESA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9014
Country	:	US
Telephone Number	:	702-212-3008
Fax Number	:	702-933-3006

Provider Business Practice Location Address
First Line	:	2445 FIRE MESA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9014
Country	:	US
Telephone Number	:	702-212-3008
Fax Number	:	702-933-3006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	09/08/2011

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Directions to “ JACOB PARAS REED ” Practice Location

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