Provider Demographics
NPI:1114410198
Name:REED, MADELINE MARIE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:MARIE
Last Name:REED
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:110 HORIZON DR. LEGACY HEALTHCARE SERVICES
Mailing Address - Street 2:SUITE 310
Mailing Address - City:RELEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615
Mailing Address - Country:US
Mailing Address - Phone:636-464-5439
Mailing Address - Fax:
Practice Address - Street 1:1481 MARBACH DR. HOMESTEAD AT HICKORY VIEW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090
Practice Address - Country:US
Practice Address - Phone:636-464-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018019701235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist