Provider Demographics
NPI:1023730249
Name:REED, HEATHER ROSE (BS)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ROSE
Last Name:REED
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:ROSE
Other - Last Name:BERNTSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1021 W 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086-4619
Mailing Address - Country:US
Mailing Address - Phone:580-622-4010
Mailing Address - Fax:
Practice Address - Street 1:202 S WASHITA AVE
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:OK
Practice Address - Zip Code:73098-7820
Practice Address - Country:US
Practice Address - Phone:405-665-4385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator