Individual
TANIESHA IVY REDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
30150 TELEGRAPH RD, BINGHAM FARMS, MI 48025-4519
(313) 363-1247
Mailing address
16729 FERGUSON ST, DETROIT, MI 48235-3444
(313) 363-1247
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401222577
MI
Other
Enumeration date
11/26/2016
Last updated
01/04/2023
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