Provider Demographics
NPI:1710187893
Name:REIVES, RASHIDA RENEE
Entity Type:Individual
Prefix:
First Name:RASHIDA
Middle Name:RENEE
Last Name:REIVES
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 1:716 TOWNSEND FARM DR
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9049
Mailing Address - Country:US
Mailing Address - Phone:336-350-0777
Mailing Address - Fax:
Practice Address - Street 1:716 TOWNSEND FARM DR
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9049
Practice Address - Country:US
Practice Address - Phone:336-330-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
252Y00000X
NC9779072252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency