Provider Demographics
NPI:1841794831
Name:REINERI, NICOLE D (PLPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:D
Last Name:REINERI
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7309 OAKRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63016-3441
Mailing Address - Country:US
Mailing Address - Phone:636-222-3966
Mailing Address - Fax:636-748-2260
Practice Address - Street 1:7309 OAKRIDGE TRL
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:MO
Practice Address - Zip Code:63016-3441
Practice Address - Country:US
Practice Address - Phone:636-222-3966
Practice Address - Fax:636-748-2260
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional