Provider Demographics
NPI:1609089713
Name:REID, AIDA RACQUEL (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:AIDA
Middle Name:RACQUEL
Last Name:REID
Suffix:
Gender:F
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 1:10959 E MESQUITE VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-6710
Mailing Address - Country:US
Mailing Address - Phone:520-245-3539
Mailing Address - Fax:520-760-9454
Practice Address - Street 1:10959 E MESQUITE VALLEY TRL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85749-6710
Practice Address - Country:US
Practice Address - Phone:520-245-3539
Practice Address - Fax:520-760-9454
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist