Provider Demographics
NPI:1144272147
Name:REEVES, KRISTIE MARIE (AUD CCC-A)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:MARIE
Last Name:REEVES
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4056
Mailing Address - Country:US
Mailing Address - Phone:813-265-2255
Mailing Address - Fax:813-265-3355
Practice Address - Street 1:2445 TAMPA RD STE H
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-5849
Practice Address - Country:US
Practice Address - Phone:800-277-1182
Practice Address - Fax:813-265-3355
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY995231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist