Provider Demographics
NPI:1962025064
Name:REED, JORDAN ANN (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:ANN
Last Name:REED
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:ANN
Other - Last Name:COPPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:789 HOLTON DR
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3757
Mailing Address - Country:US
Mailing Address - Phone:402-649-3994
Mailing Address - Fax:
Practice Address - Street 1:789 HOLTON DR
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3757
Practice Address - Country:US
Practice Address - Phone:712-546-1718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095542225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist