Provider Demographics
NPI:1720089667
Name:REINHOLTZ, RHONDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:
Last Name:REINHOLTZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 N BLACKHAWK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3357
Mailing Address - Country:US
Mailing Address - Phone:608-441-6159
Mailing Address - Fax:608-663-5928
Practice Address - Street 1:702 N BLACKHAWK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3357
Practice Address - Country:US
Practice Address - Phone:608-441-6159
Practice Address - Fax:608-663-5928
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2097057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000084001Medicare ID - Type Unspecified