Provider Demographics
NPI:1861838310
Name:REED, MARCIE J (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MARCIE
Middle Name:J
Last Name:REED
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 N 182ND RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT DALE
Mailing Address - State:NE
Mailing Address - Zip Code:68423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1045 182ND
Practice Address - Street 2:
Practice Address - City:PLEASANT DALE
Practice Address - State:NE
Practice Address - Zip Code:68423-9033
Practice Address - Country:US
Practice Address - Phone:402-613-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE358235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist