Individual provider · NPI-1

Alieizoria Redd, LCSW

Social Worker, Clinical · Ellenwood, GA

NPI number1417973199
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1417973199
Entity type
Individual (NPI-1)
Name
Ms. Alieizoria Redd
Credential
LCSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 14, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical2884GAYes

Practice location

645 Morgans Trce
Ellenwood, GA 30294-4511

Phone 678-565-8596

Mailing address

645 Morgans Trce
Ellenwood, GA 30294-4511

Phone 678-565-8596

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