Basic Information
| Provider Information | |||||||||
| NPI: | 1740488428 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REITER | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4602 GREENWOOD PL | ||||||||
| Address2: | APT. 6 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900272699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3239730105 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1172 TELEGRAPH RD. | ||||||||
| Address2: | |||||||||
| City: | SANTA FE SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5628010318 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 01/29/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.