Provider Demographics
NPI:1366544355
Name:REITHER, RICHARD E (MA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:REITHER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8455 N MILLBROOK AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2152
Mailing Address - Country:US
Mailing Address - Phone:559-432-5805
Mailing Address - Fax:559-432-5819
Practice Address - Street 1:8455 N MILLBROOK AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2152
Practice Address - Country:US
Practice Address - Phone:559-432-5805
Practice Address - Fax:559-432-5819
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25794106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist