Provider Demographics
NPI:1013745215
Name:DEMAREE, REAGAN NICOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:NICOLE
Last Name:DEMAREE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7217 TELECOM PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2205
Mailing Address - Country:US
Mailing Address - Phone:972-495-6986
Mailing Address - Fax:
Practice Address - Street 1:7217 TELECOM PKWY STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2205
Practice Address - Country:US
Practice Address - Phone:972-495-6986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist