Individual
MARY D REDDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
154 E HILL DR, MADISON, MS 39110-8962
(601) 607-7749
Mailing address
154 E HILL DR, MADISON, MS 39110-8962
(601) 607-7749
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C0533
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118533
—
MS
Enumeration date
12/15/2006
Last updated
07/09/2007
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