Provider Demographics
NPI:1801121470
Name:REID, KATHY (DOULA, LMT, PES)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:DOULA, LMT, PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2976 METROPOLITAN WAY
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2237
Mailing Address - Country:US
Mailing Address - Phone:970-623-1297
Mailing Address - Fax:
Practice Address - Street 1:2976 METROPOLITAN WAY
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-2237
Practice Address - Country:US
Practice Address - Phone:970-623-1297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula