Provider Demographics
NPI:1437170859
Name:REED, BRENDA C (PSYD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:C
Last Name:REED
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7635 W OKLAHOMA AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53219-3623
Mailing Address - Country:US
Mailing Address - Phone:414-732-3172
Mailing Address - Fax:
Practice Address - Street 1:7635 W OKLAHOMA AVE STE 214
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53219-3623
Practice Address - Country:US
Practice Address - Phone:414-732-3172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2456103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist