Healthcare Provider Details
I. General information
NPI: 1275745598
Provider Name (Legal Business Name): ALAN C. REIFERT LLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
995 MILLER RD
PLAINWELL MI
49080-1077
US
IV. Provider business mailing address
1143 N PEACH CT
PLAINWELL MI
49080-2013
US
V. Phone/Fax
- Phone: 269-685-9798
- Fax: 269-685-6975
- Phone: 269-685-9798
- Fax: 269-685-6975
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 6301010936 |
| License Number State | MI |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: