Provider Demographics
NPI:1104033059
Name:REED, CANDICE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PECAN ST
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-3530
Mailing Address - Country:US
Mailing Address - Phone:870-853-2864
Mailing Address - Fax:870-853-8264
Practice Address - Street 1:800 PECAN ST
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-3530
Practice Address - Country:US
Practice Address - Phone:870-853-2864
Practice Address - Fax:870-853-8264
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist