MEDICARE: MRS. CYNTHIA LANNETTE REED MA, MS, BCBA, LBA

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	2084P0005X	Neurodevelopmental Disabilities Physician	2021-006	AL
2	103K00000X	Behavior Analyst	2021-006	AL

General Provider Information

NPI Number	:	1578155818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CYNTHIA LANNETTE REED MA, MS, BCBA, LBA

Provider Business Mailing Address
First Line	:	190 LIME QUARRY RD STE 203
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-8976
Country	:	US
Telephone Number	:	256-651-6136
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 LIME QUARRY RD STE 203
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35758-8976
Country	:	US
Telephone Number	:	256-651-6136
Fax Number	:

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

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	10/31/2022

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