Provider Demographics
NPI:1932446648
Name:REED, MARY PATRICIA (MS, SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:PATRICIA
Last Name:REED
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:PATRICIA
Other - Last Name:KLEINECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, SLP
Mailing Address - Street 1:12329 CEDAR BEND DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-7010
Mailing Address - Country:US
Mailing Address - Phone:972-824-3917
Mailing Address - Fax:
Practice Address - Street 1:12329 CEDAR BEND DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-7010
Practice Address - Country:US
Practice Address - Phone:972-824-3917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104918235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist