Provider Demographics
NPI:1245737238
Name:REEVES, RAKIYAH Q (QDDP, QIDP,QMHP)
Entity Type:Individual
Prefix:
First Name:RAKIYAH
Middle Name:Q
Last Name:REEVES
Suffix:
Gender:F
Credentials:QDDP, QIDP,QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 AVALON DR # F
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-4780
Mailing Address - Country:US
Mailing Address - Phone:980-390-3940
Mailing Address - Fax:
Practice Address - Street 1:122 AVALON DR # F
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-4780
Practice Address - Country:US
Practice Address - Phone:980-390-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2018-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC473325376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide