Provider Demographics
NPI:1346456712
Name:REINHARDT-RUPRECHT, KRISTA MARCELLE (MA)
Entity Type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:MARCELLE
Last Name:REINHARDT-RUPRECHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:M
Other - Last Name:REINHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:104 N HARRISON AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2310
Mailing Address - Country:US
Mailing Address - Phone:303-815-3984
Mailing Address - Fax:
Practice Address - Street 1:104 N HARRISON AVE UNIT A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2310
Practice Address - Country:US
Practice Address - Phone:303-815-3984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC.0105019101Y00000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist