Provider Demographics
NPI:1578187688
Name:REINSMITH, RICHARD (MA LLP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:REINSMITH
Suffix:
Gender:M
Credentials:MA LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 IROQUOIS PL
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4638
Mailing Address - Country:US
Mailing Address - Phone:734-645-1652
Mailing Address - Fax:
Practice Address - Street 1:1420 IROQUOIS PL
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4638
Practice Address - Country:US
Practice Address - Phone:734-645-1652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361000583103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical