Provider Demographics
NPI:1295048080
Name:REED, NINA DENISE
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:DENISE
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:DENISE
Other - Last Name:GUYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:605 SW 155TH PL STE 140
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-7604
Mailing Address - Country:US
Mailing Address - Phone:805-258-2628
Mailing Address - Fax:
Practice Address - Street 1:605 SW 155TH PL STE 140
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-7604
Practice Address - Country:US
Practice Address - Phone:805-258-2628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106018235Z00000X
OK6034235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist