Individual
LISA DIANE REINBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
143 POTTLE RD, OXFORD, ME 04270-3362
(207) 743-0171
(207) 743-6959
Mailing address
143 POTTLE RD, OXFORD, ME 04270-3362
(207) 743-0171
(207) 743-6959
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC10368
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432646799
—
ME
01
—
LC10368
LICENSE
ME
Enumeration date
12/26/2007
Last updated
09/14/2011
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