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:
Health care specialties
| Specialty | Code | License # | 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 6 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 | 1437214350 | NPPES |
| Georgia | MEDICAID | 00024706 |
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