Provider Demographics
NPI:1912072760
Name:REED, KATIE (CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC SLP
Mailing Address - Street 1:1240 MARBELLA PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7906
Mailing Address - Country:US
Mailing Address - Phone:813-341-2726
Mailing Address - Fax:813-341-2755
Practice Address - Street 1:1240 MARBELLA PLAZA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7906
Practice Address - Country:US
Practice Address - Phone:813-341-2726
Practice Address - Fax:813-341-2755
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8870235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890820600Medicaid