Provider Demographics
NPI:1609753086
Name:REEVER, KEICHEA L (EDD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:KEICHEA
Middle Name:L
Last Name:REEVER
Suffix:
Gender:F
Credentials:EDD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 E FORHAN ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-2245
Mailing Address - Country:US
Mailing Address - Phone:562-668-1774
Mailing Address - Fax:
Practice Address - Street 1:326 E FORHAN ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-2245
Practice Address - Country:US
Practice Address - Phone:562-668-1774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP9889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty