Reddick, Consuelo

Reddick, Consuelo is an sole proprietor health care provider with primary practice located at 77 E Crossville Rd Ste. 206, Roswell GA 30075-5815. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is her primary health care specialty. Reddick, Consuelo can be contacted via phone (770) 552-4655.

Contact Information

Primary practice address
77 E Crossville Rd Ste. 206 Roswell GA 30075-5815
Phone: (770) 552-4655
Fax: (770) 552-4282
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 044067 Georgia
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X G133049 California
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X G133049 California
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 044067 Georgia

Profile Details

NPI number 1437214350
LBN Legal business name Reddick, Consuelo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 22nd, 2006
Last updated Jun 13th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437214350 NPPES
Georgia MEDICAID 00024706

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