Provider Demographics
NPI:1285159269
Name:REED, AMY ELAINE (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELAINE
Last Name:REED
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 S WOODMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45213-2011
Mailing Address - Country:US
Mailing Address - Phone:513-484-1022
Mailing Address - Fax:
Practice Address - Street 1:8185 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6809
Practice Address - Country:US
Practice Address - Phone:513-398-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD4683133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric