Provider Demographics
NPI:1760654404
Name:REDDICK, PATRICIA P
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:P
Last Name:REDDICK
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 1:8505 E VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-6768
Mailing Address - Country:US
Mailing Address - Phone:480-484-5077
Mailing Address - Fax:
Practice Address - Street 1:8505 E VALLEY VIEW RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-6768
Practice Address - Country:US
Practice Address - Phone:480-484-5077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3896225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3896OtherOCCUPATIONAL THERAPIST