Provider Demographics
NPI:1770838781
Name:REEDY, KEELY (BHRS)
Entity Type:Individual
Prefix:
First Name:KEELY
Middle Name:
Last Name:REEDY
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BOWERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-7704
Mailing Address - Country:US
Mailing Address - Phone:405-593-6897
Mailing Address - Fax:
Practice Address - Street 1:110 BOWERWOOD DR
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-7704
Practice Address - Country:US
Practice Address - Phone:405-593-6897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health