Provider Demographics
NPI:1912564642
Name:REEDER, SANDY L (MT-BC)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:L
Last Name:REEDER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6671
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33508-6011
Mailing Address - Country:US
Mailing Address - Phone:314-913-1596
Mailing Address - Fax:
Practice Address - Street 1:406 RONELE DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7424
Practice Address - Country:US
Practice Address - Phone:314-913-1596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist