MEDICARE: CRYSTAL 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	235Z00000X	Speech-Language Pathologist	4080	KY

General Provider Information

NPI Number	:	1528407848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL REED

Provider Business Mailing Address
First Line	:	6105 KEY PIKE
Second Line	:
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-8633
Country	:	US
Telephone Number	:	606-407-1003
Fax Number	:

Provider Business Practice Location Address
First Line	:	6105 KEY PIKE
Second Line	:
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-8633
Country	:	US
Telephone Number	:	606-407-1003
Fax Number	:

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

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	11/10/2016

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Directions to “ CRYSTAL REED ” Practice Location

Language	Start Address	Practice Location

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