Provider Demographics
NPI:1982323176
Name:REDDON, PERRY B
Entity Type:Individual
Prefix:MRS
First Name:PERRY
Middle Name:B
Last Name:REDDON
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 1:413 N 4TH ST W
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-3402
Mailing Address - Country:US
Mailing Address - Phone:307-857-7070
Mailing Address - Fax:
Practice Address - Street 1:413 N 4TH ST W
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3402
Practice Address - Country:US
Practice Address - Phone:307-857-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool