Provider Demographics
NPI:1376109884
Name:REESE, HUNTER LOGAN
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:LOGAN
Last Name:REESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 SPANGLER DR
Mailing Address - Street 2:
Mailing Address - City:DRY FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24549-3933
Mailing Address - Country:US
Mailing Address - Phone:434-251-3876
Mailing Address - Fax:
Practice Address - Street 1:39 BANK ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-1129
Practice Address - Country:US
Practice Address - Phone:434-432-2761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000069235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist