| Dretona T. Maddox, Licensed Clinical Social Worker | |
|
1410 3rd St Ste 2 Riverside CA 92507-3454 | |
| (909) 471-0697 | |
| (951) 405-4476 |
| Full Name | Dretona T. Maddox, Licensed Clinical Social Worker |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1410 3rd St Ste 2, Riverside, California |
| Authorized Official Name and Position | Dretona T. Maddox (NURSE SOCIAL WORK PRACTITIONER) |
| Authorized Official Contact | 9094710697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dretona T. Maddox, Licensed Clinical Social Worker 1410 3rd St Ste 2 Riverside CA 92507-3454 Ph: (909) 471-0697 | Dretona T. Maddox, Licensed Clinical Social Worker 1410 3rd St Ste 2 Riverside CA 92507-3454 Ph: (909) 471-0697 |
| NPI Number | 1245833524 |
|---|---|
| Provider Enumeration Date | 11/18/2020 |
| Last Update Date | 11/20/2020 |
| Certification Date | 11/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245833524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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