Provider Demographics
NPI:1871824268
Name:WOODS REDDICK, LARONDA AKISHA (MED, CM)
Entity Type:Individual
Prefix:MRS
First Name:LARONDA
Middle Name:AKISHA
Last Name:WOODS REDDICK
Suffix:
Gender:F
Credentials:MED, CM
Other - Prefix:
Other - First Name:LARONDA
Other - Middle Name:AKISHA
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CM
Mailing Address - Street 1:1201 ARLINGTON ST STE G
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4072
Mailing Address - Country:US
Mailing Address - Phone:580-332-6851
Mailing Address - Fax:580-310-6047
Practice Address - Street 1:1201 ARLINGTON ST STE G
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4072
Practice Address - Country:US
Practice Address - Phone:580-332-6851
Practice Address - Fax:580-310-6047
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator