Provider Demographics
NPI:1063024453
Name:REINERT, BLYTHE ALLISON (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:BLYTHE
Middle Name:ALLISON
Last Name:REINERT
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 W WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51103-1824
Mailing Address - Country:US
Mailing Address - Phone:620-617-3705
Mailing Address - Fax:
Practice Address - Street 1:211 10TH ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:NE
Practice Address - Zip Code:68784-5014
Practice Address - Country:US
Practice Address - Phone:402-287-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2450225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist