Provider Demographics
NPI:1790062941
Name:REEVES, MARTHA CHRISTINE
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:CHRISTINE
Last Name:REEVES
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 1:300 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:VA
Mailing Address - Zip Code:22821-9229
Mailing Address - Country:US
Mailing Address - Phone:540-421-0451
Mailing Address - Fax:
Practice Address - Street 1:300 SUNSET DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:VA
Practice Address - Zip Code:22821-9229
Practice Address - Country:US
Practice Address - Phone:540-421-0451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001588235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist