Provider Demographics
NPI:1366638694
Name:REDDINGER, MICHELLE LEANN (CRC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEANN
Last Name:REDDINGER
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1473 MOLLIE DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-2489
Mailing Address - Country:US
Mailing Address - Phone:815-942-4940
Mailing Address - Fax:
Practice Address - Street 1:1473 MOLLIE DR
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-2489
Practice Address - Country:US
Practice Address - Phone:815-942-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor