Provider Demographics
NPI:1588473599
Name:REED, SHANAYL (DOULA, CLC, CHW)
Entity type:Individual
Prefix:
First Name:SHANAYL
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:DOULA, CLC, CHW
Other - Prefix:
Other - First Name:SHANAYL
Other - Middle Name:
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOULA, CLC, CHW
Mailing Address - Street 1:5590 DEVONSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-3235
Mailing Address - Country:US
Mailing Address - Phone:313-358-5701
Mailing Address - Fax:
Practice Address - Street 1:5590 DEVONSHIRE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-3235
Practice Address - Country:US
Practice Address - Phone:313-358-5701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI374J00000X, 172V00000X
174N00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374U00000XNursing Service Related ProvidersHome Health Aide