Provider Demographics
NPI:1972934164
Name:REFFNER, MICHAEL T (EDS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:T
Last Name:REFFNER
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WILLARD WAY
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5729
Mailing Address - Country:US
Mailing Address - Phone:617-326-3779
Mailing Address - Fax:
Practice Address - Street 1:130 WILLARD WAY
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502
Practice Address - Country:US
Practice Address - Phone:617-326-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health