Provider Demographics
NPI:1376534230
Name:REED, MARNA (LP)
Entity Type:Individual
Prefix:MS
First Name:MARNA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 HIGHWAY 55
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5147
Mailing Address - Country:US
Mailing Address - Phone:763-546-6718
Mailing Address - Fax:763-546-6725
Practice Address - Street 1:4825 HIGHWAY 55
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-5147
Practice Address - Country:US
Practice Address - Phone:763-546-6718
Practice Address - Fax:763-546-6725
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health