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NPI Code Detail

MEDICARE: MS. ANDREA KIM REINHOLZ M. ED, BCBA

MEDICARE: MS. ANDREA KIM REINHOLZ M. ED, BCBA
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
1103K00000XBehavior Analyst1-14-9829WA

General Provider Information

NPI Number : 1659776813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA KIM REINHOLZ M. ED, BCBA
Provider Business Mailing Address
First Line : 2366 EASTLAKE AVE E STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98102-3391
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2366 EASTLAKE AVE E STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98102-3391
Country : US
Telephone Number : 206-829-9328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2014
Last Update Date : 09/27/2016

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