Provider Demographics
NPI:1619750502
Name:REED, MCKENNA ELISE (MS)
Entity Type:Individual
Prefix:MRS
First Name:MCKENNA
Middle Name:ELISE
Last Name:REED
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 FALLS RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24445-2201
Mailing Address - Country:US
Mailing Address - Phone:540-816-8470
Mailing Address - Fax:
Practice Address - Street 1:560 W INDIAN VALLEY RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-2803
Practice Address - Country:US
Practice Address - Phone:540-965-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001135235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist