Provider Demographics
NPI:1356956718
Name:REUTER, EILEEN P
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:P
Last Name:REUTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 N DELAWARE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT BETHEL
Mailing Address - State:PA
Mailing Address - Zip Code:18343-5254
Mailing Address - Country:US
Mailing Address - Phone:862-268-4481
Mailing Address - Fax:
Practice Address - Street 1:2445 N DELAWARE DR
Practice Address - Street 2:
Practice Address - City:MOUNT BETHEL
Practice Address - State:PA
Practice Address - Zip Code:18343-5254
Practice Address - Country:US
Practice Address - Phone:862-268-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA8F23-HK0-QX00Medicaid
PA8F23HK0QX00Medicaid