Provider Demographics
NPI:1356742811
Name:REEDY, AUBRIE LYNN
Entity type:Individual
Prefix:
First Name:AUBRIE
Middle Name:LYNN
Last Name:REEDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AUBRIE
Other - Middle Name:LYNN
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-1806
Mailing Address - Country:US
Mailing Address - Phone:912-434-6439
Mailing Address - Fax:912-330-1074
Practice Address - Street 1:109 MEADOWS DR
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-1806
Practice Address - Country:US
Practice Address - Phone:912-434-6439
Practice Address - Fax:912-330-1074
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional