Provider Demographics
NPI:1366564791
Name:REINHALTER, MARIANNE (LICSW)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:REINHALTER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 TREMONT ST
Mailing Address - Street 2:SUITE # 30
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5301
Mailing Address - Country:US
Mailing Address - Phone:207-497-2996
Mailing Address - Fax:207-497-3467
Practice Address - Street 1:30 TREMONT ST
Practice Address - Street 2:SUITE # 30
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5301
Practice Address - Country:US
Practice Address - Phone:207-497-2996
Practice Address - Fax:207-497-3467
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA730051OtherTUFTS
MAP04935OtherBCBS