Provider Demographics
NPI:1588343552
Name:REAVES, JENNIFER HOOD
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HOOD
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 1:3235 POST WOODS DR APT J
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3485
Mailing Address - Country:US
Mailing Address - Phone:470-216-9698
Mailing Address - Fax:
Practice Address - Street 1:3113 ROSWELL RD STE 204
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5500
Practice Address - Country:US
Practice Address - Phone:770-421-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program