Provider Demographics
NPI:1609368026
Name:REEDY, KATHLEEN MONICA
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MONICA
Last Name:REEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 WOODBROOK CIR N APT D
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3162
Mailing Address - Country:US
Mailing Address - Phone:614-395-1043
Mailing Address - Fax:
Practice Address - Street 1:524 W BROAD ST # B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2775
Practice Address - Country:US
Practice Address - Phone:614-395-1043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor