Provider Demographics
NPI:1710766365
Name:REIMER, ELIZABETH (MS, LAC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:REIMER
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 N CARLSBAD TRCE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5811
Mailing Address - Country:US
Mailing Address - Phone:214-288-0031
Mailing Address - Fax:479-255-4334
Practice Address - Street 1:109 N 48TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-3743
Practice Address - Country:US
Practice Address - Phone:214-288-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2206012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health