Provider Demographics
NPI:1659261675
Name:REED, ESE K
Entity type:Individual
Prefix:
First Name:ESE
Middle Name:K
Last Name:REED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ESE
Other - Middle Name:K
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2443 DIAMOND CT
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-4216
Mailing Address - Country:US
Mailing Address - Phone:313-469-4336
Mailing Address - Fax:
Practice Address - Street 1:2443 DIAMOND CT
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-4216
Practice Address - Country:US
Practice Address - Phone:313-469-4336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X
MI174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No372500000XNursing Service Related ProvidersChore Provider