Provider Demographics
NPI:1366053647
Name:REINARD, LIZZI VARGA (MA)
Entity type:Individual
Prefix:MRS
First Name:LIZZI
Middle Name:VARGA
Last Name:REINARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LIZZI
Other - Middle Name:
Other - Last Name:VARGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3316 PRESTON DR
Mailing Address - Street 2:
Mailing Address - City:GRANITE CITY
Mailing Address - State:IL
Mailing Address - Zip Code:62040-5309
Mailing Address - Country:US
Mailing Address - Phone:618-709-1313
Mailing Address - Fax:
Practice Address - Street 1:900 ROYAL HEIGHTS RD STE 2150
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5457
Practice Address - Country:US
Practice Address - Phone:618-744-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health