Provider Demographics
NPI:1427252311
Name:REINER, LOUISE ANN (LPSYA)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:ANN
Last Name:REINER
Suffix:
Gender:F
Credentials:LPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-1332
Mailing Address - Country:US
Mailing Address - Phone:631-725-1715
Mailing Address - Fax:631-725-9549
Practice Address - Street 1:71 FERRY RD
Practice Address - Street 2:
Practice Address - City:SAG HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11963-1332
Practice Address - Country:US
Practice Address - Phone:631-725-1715
Practice Address - Fax:631-725-9549
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYL000467102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYL000467OtherLICENSED PSYCHOANALYST
P951348OtherNAAP CERTIFICATION NUMBER