Provider Demographics
NPI:1043591696
Name:REED, JACOB PARAS
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:PARAS
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 FIRE MESA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9014
Mailing Address - Country:US
Mailing Address - Phone:702-212-3008
Mailing Address - Fax:702-933-3006
Practice Address - Street 1:2445 FIRE MESA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9014
Practice Address - Country:US
Practice Address - Phone:702-212-3008
Practice Address - Fax:702-933-3006
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker