Provider Demographics
NPI:1730365800
Name:REINSMA, KATHY ANNE (MA)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:ANNE
Last Name:REINSMA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:KATHIE
Other - Middle Name:
Other - Last Name:GIESELMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT, LPCC
Mailing Address - Street 1:11657 PONDVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-2629
Mailing Address - Country:US
Mailing Address - Phone:952-992-0023
Mailing Address - Fax:
Practice Address - Street 1:5851 DULUTH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-3946
Practice Address - Country:US
Practice Address - Phone:952-992-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55690106H00000X
MN1900106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist