Basic Information
Provider Information
NPI: 1588003347
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REIHANI
FirstName: LANA
MiddleName: S.
NamePrefix: MISS
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7850 JEFFERSON ST NE
Address2: SUITE 300
City: ALBUQUERQUE
State: NM
PostalCode: 871094315
CountryCode: US
TelephoneNumber: 5058841114
FaxNumber: 5058566320
Practice Location
Address1: 7850 JEFFERSON ST NE STE 300
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871094314
CountryCode: US
TelephoneNumber: 5058841114
FaxNumber: 5058566320
Other Information
ProviderEnumerationDate: 06/14/2013
LastUpdateDate: 10/31/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X0161231NMY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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