Provider Demographics
NPI:1558787705
Name:REED, MICHELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N VINEYARD BLVD STE A3255645
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-3950
Mailing Address - Country:US
Mailing Address - Phone:808-501-0110
Mailing Address - Fax:
Practice Address - Street 1:200 N VINEYARD BLVD STE A3255645
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-3950
Practice Address - Country:US
Practice Address - Phone:808-501-0110
Practice Address - Fax:808-204-2488
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1895225X00000X, 225XL0004X
NC9052225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist