Provider Demographics
NPI:1245573740
Name:REEDER, MELISSA THERESA (AS)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:THERESA
Last Name:REEDER
Suffix:
Gender:F
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CORDAGE CIRCLE PARK
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-830-3444
Mailing Address - Fax:508-830-3434
Practice Address - Street 1:36 CORDAGE PARK CIR
Practice Address - Street 2:SUITE 305
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7331
Practice Address - Country:US
Practice Address - Phone:508-830-3444
Practice Address - Fax:508-830-3434
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator