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General NPI Number Information
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NPI Number | 1851890297
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Entity Type | Individual
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Provider Name | SCOTT EDWARD REISINGER PSYD
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Gender | Male
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 3600 KOLBE RD STE 120
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City | LORAIN
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State | OH
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Zip | 44053-1652
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Country | US
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Telephone | 440-960-3954
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Fax | 440-960-3956
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Provider Business Mailing Address
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Address Line | 3600 KOLBE RD STE 120
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City | LORAIN
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State | OH
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Zip | 44053-1652
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Country | US
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Telephone | 440-960-3954
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Fax | 440-960-3956
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P.07692
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License Number State | OH
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