Provider Demographics
NPI:1912729203
Name:REID, KATHRYN L
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:REID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:L
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19001 E WHITAKER PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-4950
Mailing Address - Country:US
Mailing Address - Phone:504-321-5659
Mailing Address - Fax:
Practice Address - Street 1:19001 E WHITAKER PL
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-4950
Practice Address - Country:US
Practice Address - Phone:504-321-5659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician