Provider Demographics
NPI:1427263425
Name:REIN, JUDITH ANN (PSY D)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:REIN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2016
Mailing Address - Street 2:128 NEWPORT DRIVE
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-5516
Mailing Address - Country:US
Mailing Address - Phone:724-464-2252
Mailing Address - Fax:724-463-1174
Practice Address - Street 1:128 NEWPORT DR
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2418
Practice Address - Country:US
Practice Address - Phone:724-464-2252
Practice Address - Fax:724-463-1174
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-12
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007397L103T00000X, 103TC0700X, 103TC2200X, 103TF0000X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities