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General NPI Number Information
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NPI Number | 1891656401
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Entity Type | Individual
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Provider Name | MICHAEL DARYL REDD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 7310 EDEN BROOK DR UNIT 513
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City | COLUMBIA
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State | MD
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Zip | 21046-1220
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Country | US
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Telephone | 866-968-6342
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Fax |
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Provider Business Mailing Address
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Address Line | 6655 SANTA BARBARA RD STE ELKRIDGE
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City | ELKRIDGE
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State | MD
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Zip | 21075-7500
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Country | US
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Telephone | 866-968-6342
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33987
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License Number State | MD
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