Provider Demographics
NPI:1760882856
Name:REINHARDT, DEVAN (MS OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DEVAN
Middle Name:
Last Name:REINHARDT
Suffix:
Gender:M
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 CENTRAL AVE N
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:ND
Mailing Address - Zip Code:58523-6003
Mailing Address - Country:US
Mailing Address - Phone:701-873-5342
Mailing Address - Fax:701-873-5649
Practice Address - Street 1:108 W MAIN ST
Practice Address - Street 2:STE B
Practice Address - City:BEULAH
Practice Address - State:ND
Practice Address - Zip Code:58523
Practice Address - Country:US
Practice Address - Phone:701-880-8936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
SD0816225X00000X
ND1685225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator