Provider Demographics
NPI:1427001726
Name:REESE, RICHARD (MS CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:REESE
Suffix:
Gender:M
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 WHITE WAY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-3123
Mailing Address - Country:US
Mailing Address - Phone:205-822-6316
Mailing Address - Fax:205-978-8332
Practice Address - Street 1:600 MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-4675
Practice Address - Country:US
Practice Address - Phone:205-608-2999
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist