Healthcare Provider Details

I. General information

NPI: 1437225125
Provider Name (Legal Business Name): MICHELLE ANNE REINER OTRL,CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 CAMPUS DR STE 300
PLYMOUTH MN
55441
US

IV. Provider business mailing address

4200 DAHLBERG DR STE 300
GOLDEN VALLEY MN
55422-4841
US

V. Phone/Fax

Practice location:
  • Phone: 763-520-7870
  • Fax: 763-520-7580
Mailing address:
  • Phone: 763-520-7870
  • Fax: 763-520-7580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number100573
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: