Provider Demographics
NPI:1083133060
Name:REED-SMITH, DEAUDRA SHANIQUA (MED, NCC)
Entity Type:Individual
Prefix:MRS
First Name:DEAUDRA
Middle Name:SHANIQUA
Last Name:REED-SMITH
Suffix:
Gender:F
Credentials:MED, NCC
Other - Prefix:
Other - First Name:DEAUDRA
Other - Middle Name:SHANIQUA
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, NCC
Mailing Address - Street 1:6625 TRUNK WAY UNIT I
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46221-1591
Mailing Address - Country:US
Mailing Address - Phone:912-506-2542
Mailing Address - Fax:
Practice Address - Street 1:5638 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-5042
Practice Address - Country:US
Practice Address - Phone:888-714-1927
Practice Address - Fax:317-745-9565
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health