Provider Demographics
NPI:1760622906
Name:REDDITT, GERALDINE PIATT (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:PIATT
Last Name:REDDITT
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 MEMORIAL BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1680
Mailing Address - Country:US
Mailing Address - Phone:615-364-8700
Mailing Address - Fax:
Practice Address - Street 1:1850 MEMORIAL BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1680
Practice Address - Country:US
Practice Address - Phone:615-364-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-28
Last Update Date:2009-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000004761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical