Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 23749 | TX |
N | 103T00000X | Psychologist | 23749 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 23749 | TX |
NPI | 1033209325 |
---|---|
Provider Name | Dr. Madeleine Reichert |
First Address | San Antonio, TX 78218-3078 |
Second Address | San Antonio, TX 78218-3078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2006 |
Last Update Date | 08/07/2007 |