Provider Demographics
NPI:1821206095
Name:REINSTATLER, RICHARD ROLAND (MED, LMFT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ROLAND
Last Name:REINSTATLER
Suffix:
Gender:M
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 FLOYD DR
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-4738
Mailing Address - Country:US
Mailing Address - Phone:850-265-9414
Mailing Address - Fax:
Practice Address - Street 1:337 FLOYD DR
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-4738
Practice Address - Country:US
Practice Address - Phone:850-265-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist