Provider Demographics
NPI:1780474478
Name:REDDRICK, YVETTE JUANITA
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:JUANITA
Last Name:REDDRICK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 V ST NW APT 11
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1733
Mailing Address - Country:US
Mailing Address - Phone:202-975-9068
Mailing Address - Fax:
Practice Address - Street 1:350 MAPLE DR SW APT 516
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-4640
Practice Address - Country:US
Practice Address - Phone:301-257-9654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant