Provider Demographics
NPI:1760675987
Name:NAN REINHARDT, OTR/L & ASSOC, LLC
Entity Type:Organization
Organization Name:NAN REINHARDT, OTR/L & ASSOC, LLC
Other - Org Name:CHILDREN'S THERAPY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:715-749-3890
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:ROBERTS
Mailing Address - State:WI
Mailing Address - Zip Code:54023
Mailing Address - Country:US
Mailing Address - Phone:715-749-3890
Mailing Address - Fax:715-749-4081
Practice Address - Street 1:204 W WARREN STREET
Practice Address - Street 2:
Practice Address - City:ROBERTS
Practice Address - State:WI
Practice Address - Zip Code:54023
Practice Address - Country:US
Practice Address - Phone:715-749-3890
Practice Address - Fax:715-749-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41231400Medicaid