MEDICARE: DR. BARBARA JEAN REINKE PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1001	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740251164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA JEAN REINKE PHD

Provider Business Mailing Address
First Line	:	628 CRESCENT CT
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53213-3858
Country	:	US
Telephone Number	:	414-453-8531
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 N MAYFAIR RD
Second Line	:	SUITE 320
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-1309
Country	:	US
Telephone Number	:	414-258-5791
Fax Number	:	414-258-5590

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	07/08/2007

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