Doctor Name: | MR. KENNETH GEORGE REINERS |
NPI Number: | 1346254893 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | 179 |
Business Practice Address: | 11330 Rosemill Ln Champlin, MN - 553162660 |
Business Phone Number: | 7633232906 |
Business Fax Number: | 7635761731 |
Mailing Address: | 11330 Rosemill Ln, CHAMPLIN |
State: | MN |
Postal Code: | 553162660 |
Phone Number: | 7633232906 |
Fax Number: | 7635761731 |
NPI Enumeration Date: | 07/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | 179 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |