Provider Demographics
NPI:1902997281
Name:LADREYT, AMELIA T (MACE, LCMHT)
Entity Type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:T
Last Name:LADREYT
Suffix:
Gender:F
Credentials:MACE, LCMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:502 EXCHANGE STREET
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801
Mailing Address - Country:US
Mailing Address - Phone:662-372-4582
Mailing Address - Fax:
Practice Address - Street 1:REGION III MENTAL HEALTH-CHEMICAL DEPENCY SERVICES
Practice Address - Street 2:920 BOONE STREET
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804
Practice Address - Country:US
Practice Address - Phone:662-844-3531
Practice Address - Fax:662-844-1757
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)