Provider Demographics
NPI:1083439863
Name:REED, DEVIN (171M00000X)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:171M00000X
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9976 DARROW RD APT 1
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1446
Mailing Address - Country:US
Mailing Address - Phone:216-644-1982
Mailing Address - Fax:
Practice Address - Street 1:9976 DARROW RD APT 1
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1446
Practice Address - Country:US
Practice Address - Phone:216-644-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251B00000XAgenciesCase Management