Provider Demographics
NPI:1003562117
Name:REINS, AMY LYDDY (LPA-A)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYDDY
Last Name:REINS
Suffix:
Gender:F
Credentials:LPA-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 HEEP RUN
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-5093
Mailing Address - Country:US
Mailing Address - Phone:213-804-8182
Mailing Address - Fax:
Practice Address - Street 1:589 N FM 1626 STE 307
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-3861
Practice Address - Country:US
Practice Address - Phone:213-804-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87887101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27084198OtherDMV