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NPI 1003562117

NPI 1003562117 : AMY LYDDY REINS LPA-A : BUDA, TX

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General NPI Number Information
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    NPI Number           |    1003562117
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    Entity Type          |    Individual 
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    Provider Name        |    AMY LYDDY REINS LPA-A
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/28/2022
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    Last Update Date     |    02/28/2022
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Provider Practice Location Address
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    Address Line         |    589 N FM 1626 STE 307 
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    City                 |    BUDA
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    State                |    TX
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    Zip                  |    78610-3861
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    Country              |    US
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    Telephone            |    213-804-8182
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1311 HEEP RUN 
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    City                 |    BUDA
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    State                |    TX
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    Zip                  |    78610-5093
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    Country              |    US
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    Telephone            |    213-804-8182
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    87887
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    License Number State |    TX
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