Provider Demographics
NPI:1942078191
Name:REITSMA, AIMEE E
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:E
Last Name:REITSMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20784 588TH LN
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-8569
Mailing Address - Country:US
Mailing Address - Phone:507-400-5097
Mailing Address - Fax:
Practice Address - Street 1:20784 588TH LN
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-8569
Practice Address - Country:US
Practice Address - Phone:507-400-5097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician