| NPI | 1760774608 |
|---|---|
| Former Name | ANDREA L REASONER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics (Licence: IA 28174) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 28174) |
| 2080P0008X Pediatrics Neurodevelopmental Disabilities (Licence: IA 28174) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2021-12-29 |