Provider Demographics
NPI:1588099147
Name:REID, EMMA LEANNE (RCP-RRT)
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:LEANNE
Last Name:REID
Suffix:
Gender:F
Credentials:RCP-RRT
Other - Prefix:MS
Other - First Name:EMMA
Other - Middle Name:LEANNE
Other - Last Name:WOODIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RCP-RRT
Mailing Address - Street 1:38108 HIGH RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223
Mailing Address - Country:US
Mailing Address - Phone:909-771-9332
Mailing Address - Fax:
Practice Address - Street 1:38108 HIGH RIDGE DRIVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223
Practice Address - Country:US
Practice Address - Phone:909-771-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26150227800000X
CA99026227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified