Doctor Name: | OFA MELIAME REDDING |
NPI Number: | 1922328533 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SOCIAL WORKER |
License Number: | SC60137409 |
Business Practice Address: | 1 Colville Street Nespelem, WA - 99155 |
Business Phone Number: | 5096342727 |
Business Fax Number: | |
Mailing Address: | Po Box 504, NESPELEM |
State: | WA |
Postal Code: | 991550504 |
Phone Number: | 5096342727 |
Fax Number: | 5096342781 |
NPI Enumeration Date: | 06/04/2010 |
NPI Last Update Date: | 06/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | SC60137409 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |