Provider Demographics
NPI:1720754203
Name:REID, MONICA BLAIR (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:BLAIR
Last Name:REID
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 KERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-4600
Mailing Address - Country:US
Mailing Address - Phone:908-656-4241
Mailing Address - Fax:
Practice Address - Street 1:1058 KERWOOD CIR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-4600
Practice Address - Country:US
Practice Address - Phone:908-656-4241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10231235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty