Provider Demographics
NPI:1275745598
Name:REIFERT, ALAN C (LLP)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:C
Last Name:REIFERT
Suffix:
Gender:M
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 N PEACH CT
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-2013
Mailing Address - Country:US
Mailing Address - Phone:269-685-9798
Mailing Address - Fax:269-685-6975
Practice Address - Street 1:995 MILLER RD
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1077
Practice Address - Country:US
Practice Address - Phone:269-685-9798
Practice Address - Fax:269-685-6975
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010936103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling