Provider Demographics
NPI:1225915952
Name:REANDO, CATHERINE (MS, RD, LD, IBCLC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:REANDO
Suffix:
Gender:F
Credentials:MS, RD, LD, IBCLC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:DALLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD
Mailing Address - Street 1:1025 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-2079
Mailing Address - Country:US
Mailing Address - Phone:314-210-3177
Mailing Address - Fax:
Practice Address - Street 1:1025 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PARK HILLS
Practice Address - State:MO
Practice Address - Zip Code:63601-2079
Practice Address - Country:US
Practice Address - Phone:314-210-3177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOL-301081174N00000X
MO2013036530133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN