Provider Demographics
NPI:1871221598
Name:REED, ANNA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BREWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5501 PARK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-5901
Mailing Address - Country:US
Mailing Address - Phone:817-236-8801
Mailing Address - Fax:
Practice Address - Street 1:5501 PARK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-5901
Practice Address - Country:US
Practice Address - Phone:817-236-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112748235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist