Maddox, Jeanetta Rena
Maddox, Jeanetta Rena is an individual health care provider with primary practice located at 1307 E Elm St , Athens AL 35611-5318. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Maddox, Jeanetta Rena can be contacted via phone (256) 232-3661.Contact Information
Primary practice address
1307 E Elm St
Athens AL 35611-5318
Phone: (256) 232-3661
Fax: (256) 355-6092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1104098987 |
|---|---|
| LBN Legal business name | Maddox, Jeanetta Rena |
| Credentials | M.S.W. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 1st, 2008 |
| Last updated | Jul 16th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104098987 | NPPES |
| Other | 51547790 | BCBS |
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