Healthcare Provider Details

I. General information

NPI: 1336611722
Provider Name (Legal Business Name): LAURA REINERT PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2018
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 SOUTH LAPORTE DR
PUEBLO WEST CO
81007-1572
US

IV. Provider business mailing address

PO BOX 7425
PUEBLO WEST CO
81007-0425
US

V. Phone/Fax

Practice location:
  • Phone: 719-357-6323
  • Fax:
Mailing address:
  • Phone: 719-429-8998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY.0004604
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: