Provider Demographics
NPI:1144604265
Name:REDDY, MUNI
Entity Type:Individual
Prefix:
First Name:MUNI
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 MCLEOD LN NE APT 104
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-2329
Mailing Address - Country:US
Mailing Address - Phone:503-501-6991
Mailing Address - Fax:
Practice Address - Street 1:5455 MCLEOD LN NE APT 104
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-2329
Practice Address - Country:US
Practice Address - Phone:503-501-6991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-18
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)