Individual
MS. LISA M REEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSP CCC-SLP
Contact information
Practice address
1004 WILDWOOD RD, AIKEN, SC 29801-3076
(803) 443-8532
Mailing address
1004 WILDWOOD RD, AIKEN, SC 29801-3076
(803) 443-8532
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3446
SC
235Z00000X
Speech-Language Pathologist
SLP005773
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814456023A
—
GA
05
—
814456023A
—
SC
Enumeration date
12/18/2006
Last updated
05/14/2014
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