Provider Demographics
NPI:1780037416
Name:REEDER, SPENCER LEE (AUD)
Entity Type:Individual
Prefix:
First Name:SPENCER
Middle Name:LEE
Last Name:REEDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 BRYAN DAIRY RD STE 340
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1365
Mailing Address - Country:US
Mailing Address - Phone:727-393-5728
Mailing Address - Fax:
Practice Address - Street 1:8200 BRYAN DAIRY RD STE 340
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1365
Practice Address - Country:US
Practice Address - Phone:727-393-5728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2126231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist