Provider Demographics
NPI:1629331574
Name:REED, ANDREA CATHERINE (MA, PHD, JD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CATHERINE
Last Name:REED
Suffix:
Gender:F
Credentials:MA, PHD, JD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:CATHERINE
Other - Last Name:MUNROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7570 W 21ST ST N STE 1026D
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1764
Mailing Address - Country:US
Mailing Address - Phone:316-729-6555
Mailing Address - Fax:
Practice Address - Street 1:7570 W 21ST ST N STE 1026D
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1764
Practice Address - Country:US
Practice Address - Phone:316-729-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2377103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral