MEDICARE: MS. QUANITA NICHOLE 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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1366770026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. QUANITA NICHOLE REED

Provider Business Mailing Address
First Line	:	2220 N CLASSEN BLVD
Second Line	:	SUITE E
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-5809
Country	:	US
Telephone Number	:	405-528-1748
Fax Number	:	405-528-1802

Provider Business Practice Location Address
First Line	:	2220 N CLASSEN BLVD
Second Line	:	SUITE E
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-5809
Country	:	US
Telephone Number	:	405-528-1748
Fax Number	:	405-528-1802

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

Provider Enumeration Date	:	11/18/2009
Last Update Date	:	11/18/2009

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