Individual
MARY K REITER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MS HSPP
Contact information
Practice address
4214 HOBSON CT, FORT WAYNE, IN 46815-8648
(260) 486-5251
(260) 486-5058
Mailing address
4214 HOBSON CT, FORT WAYNE, IN 46815-8648
(260) 486-5251
(260) 486-5058
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20130063A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204359
ANTHEM
—
01
—
0004361577
AETNA US HEALTHCARE
—
01
—
008809
VALUEOPTIONS
—
01
—
45756
CIGNA
—
Enumeration date
09/13/2005
Last updated
07/09/2007
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