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General NPI Number Information
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NPI Number | 1679278659
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Entity Type | Individual
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Provider Name | GISELLE REDDY LPC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 17 LATIMER ST
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City | HAZLEHURST
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State | GA
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Zip | 31539-6259
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Country | US
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Telephone | 912-888-8009
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Fax | 443-703-7810
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Provider Business Mailing Address
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Address Line | 17 LATIMER ST
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City | HAZLEHURST
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State | GA
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Zip | 31539-6259
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Country | US
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Telephone | 912-888-8009
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Fax | 443-703-7810
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC012997
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License Number State | GA
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