Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | CA |
NPI | 1013198365 |
---|---|
Provider Name | Dr. Tara Alexia Reed |
First Address | Rancho Palos Verdes, CA 90275-1434 |
Second Address | Long Beach, CA 90802-4431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2007 |
Last Update Date | 07/07/2014 |