Healthcare Provider Details

I. General information

NPI: 1992023725
Provider Name (Legal Business Name): LOUIS REICHERT PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9045 LA FONTANA BLVD SUITE 222
BOCA RATON FL
33434-5636
US

IV. Provider business mailing address

PO BOX 880627
BOCA RATON FL
33488-0627
US

V. Phone/Fax

Practice location:
  • Phone: 561-477-3083
  • Fax: 561-883-7169
Mailing address:
  • Phone: 561-477-3083
  • Fax: 561-883-7169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS REICHERT
Title or Position: PSYCHOLOGIST
Credential: PA
Phone: 561-477-3083