Provider Demographics
NPI:1740807452
Name:REESE, MARLA JOYCE
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:JOYCE
Last Name:REESE
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 1:707 NICHOLAS ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2921
Mailing Address - Country:US
Mailing Address - Phone:419-807-6526
Mailing Address - Fax:
Practice Address - Street 1:707 NICHOLAS ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-2921
Practice Address - Country:US
Practice Address - Phone:419-807-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide