Provider Demographics
NPI:1811395940
Name:RENO, MARGARET MARY (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MARY
Last Name:RENO
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:MARY
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC SLP
Mailing Address - Street 1:14145 SIMONE DR.
Mailing Address - Street 2:DEVELOPING CONNECTIONS INC.
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315
Mailing Address - Country:US
Mailing Address - Phone:586-566-6280
Mailing Address - Fax:586-566-1898
Practice Address - Street 1:14145 SIMONE DR.
Practice Address - Street 2:DEVELOPING CONNECTIONS INC.
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315
Practice Address - Country:US
Practice Address - Phone:586-566-6280
Practice Address - Fax:586-566-1898
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101003475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist