Organization
ROSWELL PSYCHIATRIC SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSUELO REDDICK MD (OWNER)
(770) 552-4655
Entity
Organization
Contact information
Practice address
77 E CROSSVILLE RD, STE. 206, ROSWELL, GA 30075-5815
(770) 552-4655
(770) 552-4282
Mailing address
PO BOX 1988, ROSWELL, GA 30077-1988
(770) 552-4655
(770) 552-4282
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
044067
GA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
044067
GA
Other
Enumeration date
09/24/2009
Last updated
09/24/2009
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