Provider Demographics
NPI:1437935277
Name:REED, NATHANIEL CLYDE
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:CLYDE
Last Name:REED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRANCHFIELD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6717
Mailing Address - Country:US
Mailing Address - Phone:210-318-5781
Mailing Address - Fax:
Practice Address - Street 1:5 BRANCHFIELD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-6717
Practice Address - Country:US
Practice Address - Phone:210-318-5781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician