Doctor Name: | GRETCHEN A REEVES |
NPI Number: | 1104199199 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, SLP-CCC |
License Number: | 6100 |
Business Practice Address: | 824 N 11th St Montevideo, MN - 562651629 |
Business Phone Number: | 3202698877 |
Business Fax Number: | 3202698186 |
Mailing Address: | 824 N 11th St, MONTEVIDEO |
State: | MN |
Postal Code: | 562651629 |
Phone Number: | 3202698877 |
Fax Number: | 3202698186 |
NPI Enumeration Date: | 02/22/2012 |
NPI Last Update Date: | 02/22/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 6100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |