Provider Demographics
NPI:1922781194
Name:TODD, REDDEN ANN
Entity Type:Individual
Prefix:MS
First Name:REDDEN
Middle Name:ANN
Last Name:TODD
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 1:503 E STATE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CASSOPOLIS
Mailing Address - State:MI
Mailing Address - Zip Code:49031-1107
Mailing Address - Country:US
Mailing Address - Phone:269-259-1493
Mailing Address - Fax:
Practice Address - Street 1:6418 DEANS HILL RD
Practice Address - Street 2:
Practice Address - City:BERRIEN CENTER
Practice Address - State:MI
Practice Address - Zip Code:49102-8713
Practice Address - Country:US
Practice Address - Phone:269-815-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty