Provider Demographics
NPI:1528889177
Name:REAVES, KENDALL ANNE
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:ANNE
Last Name:REAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9843 N 51ST PL
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1013
Mailing Address - Country:US
Mailing Address - Phone:480-213-1320
Mailing Address - Fax:
Practice Address - Street 1:8850 E PIMA CENTER PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4619
Practice Address - Country:US
Practice Address - Phone:480-800-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant