Healthcare Provider Details

I. General information

NPI: 1538276639
Provider Name (Legal Business Name): GINGER REDDEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAMEDDAC WUERZBURG USAHC VILSECK
APO AE
09112
DE

IV. Provider business mailing address

USAMEDDAC WUERZBURG ATTN:CREDENTIALS OFFICE UNIT 26610
APO AE
09244
DE

V. Phone/Fax

Practice location:
  • Phone: 011499662833324
  • Fax: 011499662832061
Mailing address:
  • Phone: 011499318043616
  • Fax: 011499318043241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34188
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: