Individual
MARILYN LAVETTE REDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4449 N 12TH STREET, SUITE A1, PHOENIX, AZ 85014-4596
(602) 279-1427
(602) 279-1431
Mailing address
P.O. BOX 16906, PHOENIX, AZ 85011-6906
(602) 279-1427
(602) 279-1431
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11743
AZ
385HR2055X
Child Mental Illness Respite Care
11743
AZ
Other
Enumeration date
12/28/2006
Last updated
02/09/2011
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