Provider Demographics
NPI:1740549328
Name:REED, PATRICIA GRAVES (SLP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:GRAVES
Last Name:REED
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LORETTO RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:40069-9352
Mailing Address - Country:US
Mailing Address - Phone:859-336-9023
Mailing Address - Fax:
Practice Address - Street 1:1400 LORETTO RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:KY
Practice Address - Zip Code:40069-9352
Practice Address - Country:US
Practice Address - Phone:859-336-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist