Provider Demographics
NPI:1477834869
Name:REEVES, AMY KATHLEEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHLEEN
Last Name:REEVES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Other - First Name:
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Mailing Address - Street 1:4257 HEATHER RD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1627
Mailing Address - Country:US
Mailing Address - Phone:310-953-8003
Mailing Address - Fax:
Practice Address - Street 1:3722 KATELLA AVE STE C
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3102
Practice Address - Country:US
Practice Address - Phone:562-270-2970
Practice Address - Fax:562-685-0621
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA17959235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist