| Doctor Name: | HEATHER A REISINGER |
| NPI Number: | 1659610913 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 324 E Chestnut St Coweta, OK - 744292532 |
| Business Phone Number: | 9182796565 |
| Business Fax Number: | |
| Mailing Address: | 303 N 9th St Apt 27, BROKEN ARROW |
| State: | OK |
| Postal Code: | 740122822 |
| Phone Number: | 9186255251 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 02/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |