Provider Demographics
NPI:1982188520
Name:REINITZ, ANDREA JEANNINE
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JEANNINE
Last Name:REINITZ
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 1:5350 CUMBERLAND CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47620-7951
Mailing Address - Country:US
Mailing Address - Phone:812-431-2386
Mailing Address - Fax:
Practice Address - Street 1:5350 CUMBERLAND CT
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IN
Practice Address - Zip Code:47620-7951
Practice Address - Country:US
Practice Address - Phone:812-431-2386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist