Individual
PAUL REITMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4663 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110-3300
(612) 508-9390
Mailing address
3230 ORCHARD CT, WHITE BEAR LAKE, MN 55110-5385
(612) 508-9390
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0377
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098547300
—
MN
01
—
41745RE
BLUE CROSS
MN
01
—
984241007131
PREFERRED ONE
MN
Enumeration date
07/06/2006
Last updated
04/30/2015
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