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General NPI Number Information
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NPI Number | 1659610913
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Entity Type | Individual
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Provider Name | HEATHER A REISINGER
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Gender | Female
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Dates
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Enumeration Date | 02/06/2013
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 324 E CHESTNUT ST
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City | COWETA
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State | OK
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Zip | 74429-2532
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Country | US
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Telephone | 918-279-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 303 N 9TH ST APT 27
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City | BROKEN ARROW
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State | OK
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Zip | 74012-2822
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Country | US
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Telephone | 918-625-5251
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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