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Individual

TINA I REDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADAC II, NCAC I

Contact information

Practice address
320 HOSPITAL DR, MADISON, TN 37115-4287
(615) 992-6504
Mailing address
320 HOSPITAL DR, MADISON, TN 37115-4287
(615) 992-6504
(615) 800-8956

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1070
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
84-2779012
TN
Enumeration date
11/15/2021
Last updated
11/15/2021
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