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General NPI Number Information
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NPI Number | 1407862477
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Entity Type | Individual
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Provider Name | AMY ELIZABETH REDD PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 317 W HILL ST SUITE 203A
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City | DECATUR
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State | GA
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Zip | 30030-4367
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Country | US
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Telephone | 404-388-0767
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Fax | 404-378-8029
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Provider Business Mailing Address
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Address Line | 237 WARREN ST NE
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City | ATLANTA
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State | GA
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Zip | 30317-1005
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Country | US
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Telephone | 404-388-0767
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Fax | 404-880-0133
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY002972
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License Number State | GA
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