MEDICARE: BRENDA M REED CERTIFIED OCCUPATION

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	224Z00000X	Occupational Therapy Assistant	87644	OR

General Provider Information

NPI Number	:	1831247329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA M REED CERTIFIED OCCUPATION

Provider Business Mailing Address
First Line	:	7540 N 19TH AVE STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-7967
Country	:	US
Telephone Number	:	602-324-6500
Fax Number	:	602-324-6520

Provider Business Practice Location Address
First Line	:	7540 N 19TH AVE STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-7967
Country	:	US
Telephone Number	:	602-324-6500
Fax Number	:	602-324-6500

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/26/2011

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