Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS009072L | PA |
Y | 103T00000X | Psychologist | PS009072L | PA |
NPI | 1013113182 |
---|---|
Provider Name | Dr. Michele Reimer |
First Address | Bala Cynwyd, PA 19004-3209 |
Second Address | Bala Cynwyd, PA 19004-3209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 08/07/2007 |