Provider Demographics
NPI:1396857686
Name:RENO, CLAUDETTE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDETTE
Middle Name:MARIE
Last Name:RENO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CLAUDETTE
Other - Middle Name:MARIE
Other - Last Name:RICHTER-RENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:107 W. MAIN AVE SUITE 225
Mailing Address - Street 2:BISMARCK PSYCHOLOGICAL ASSOCIATES, PLLC
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501
Mailing Address - Country:US
Mailing Address - Phone:701-751-4122
Mailing Address - Fax:701-751-1728
Practice Address - Street 1:107 W. MAIN AVE. SUITE 225
Practice Address - Street 2:BISMARCK PSYCHOLOGICAL ASSOCIATES, PLLC
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501
Practice Address - Country:US
Practice Address - Phone:701-751-4122
Practice Address - Fax:701-751-1728
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND264103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1452168Medicaid
NDN12651Medicare PIN
ND1452168Medicaid