Provider Demographics
NPI:1063604494
Name:REED, AUGUSTA M (MS, MA, CCC/SP)
Entity type:Individual
Prefix:MRS
First Name:AUGUSTA
Middle Name:M
Last Name:REED
Suffix:
Gender:F
Credentials:MS, MA, CCC/SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BLACKBERRY LANE
Mailing Address - Street 2:
Mailing Address - City:PORT WENTWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:31407
Mailing Address - Country:US
Mailing Address - Phone:912-964-1457
Mailing Address - Fax:
Practice Address - Street 1:121 MORRALL DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-8848
Practice Address - Country:US
Practice Address - Phone:843-466-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist