MEDICARE: MR. CARL O REDDING JR. MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1083682124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CARL O REDDING JR. MSW

Provider Business Mailing Address
First Line	:	3170 INDIAN TRL
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-3791
Country	:	US
Telephone Number	:	561-422-6884
Fax Number	:	561-422-7578

Provider Business Practice Location Address
First Line	:	7503 N MILITARY TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-6419
Country	:	US
Telephone Number	:	561-422-6884
Fax Number	:	561-422-7578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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