Doctor Name: | JENNIFER REDD |
NPI Number: | 1326420134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSW |
License Number: | 322073-3502 |
Business Practice Address: | 356 S Main St Blanding, UT - 845113830 |
Business Phone Number: | 4356782992 |
Business Fax Number: | 4356783116 |
Mailing Address: | 356 S Main St, BLANDING |
State: | UT |
Postal Code: | 845113830 |
Phone Number: | 4356782992 |
Fax Number: | 4356783116 |
NPI Enumeration Date: | 06/29/2015 |
NPI Last Update Date: | 06/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 322073-3502 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |