Healthcare Provider Details

I. General information

NPI: 1679443972
Provider Name (Legal Business Name): EMILY REITER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 82ND AVENUE CIR E APT 102
SARASOTA FL
34243-6339
US

IV. Provider business mailing address

3820 82ND AVENUE CIR E APT 102
SARASOTA FL
34243-6339
US

V. Phone/Fax

Practice location:
  • Phone: 781-291-1983
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number16-110
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: