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General NPI Number Information
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NPI Number | 1578816245
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Entity Type | Individual
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Provider Name | AARON MICHAEL REINA M.S., L.L.P.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 1365 S MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-2217
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Country | US
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Telephone | 734-451-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 RIDGEVIEW DR
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City | CLYDE
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State | MI
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Zip | 48049-4318
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Country | US
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Telephone | 313-680-4614
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301015331
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301015331
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6361006597
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License Number State | MI
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