Provider Demographics
NPI:1972620490
Name:REDDY, SHEELA (MS, EDD)
Entity Type:Individual
Prefix:DR
First Name:SHEELA
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MS, EDD
Other - Prefix:DR
Other - First Name:SHEELA
Other - Middle Name:
Other - Last Name:SUNDARARAJAN-REDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, EDD
Mailing Address - Street 1:7021 GARDEN WALK
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4902
Mailing Address - Country:US
Mailing Address - Phone:443-546-4810
Mailing Address - Fax:
Practice Address - Street 1:10784 HICKORY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3646
Practice Address - Country:US
Practice Address - Phone:410-964-0425
Practice Address - Fax:410-964-0515
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04313103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical