Doctor Name: | DR. KATHLEEN O'MALLEY REYNTJENS |
NPI Number: | 1003830415 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 0974 |
Business Practice Address: | 110 Delgado St Suite A Santa Fe, NM - 875012781 |
Business Phone Number: | 5058200963 |
Business Fax Number: | 5059829767 |
Mailing Address: | Po Box 32747, SANTA FE |
State: | NM |
Postal Code: | 875942747 |
Phone Number: | 5056035052 |
Fax Number: | 5059829767 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 02/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | 0974 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |