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Provider Information for 1376228262


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RAMON IGNACIO REINA


Sex: Male

NPI: 1376228262
Last Updated: 2023-06-19
Certification Date: 2023-06-19

Details

NameValue
NPI1376228262
Enumeration Date2023-06-19
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 1750 GREEN CREST DR
VICTORIA, MN 55386-9400
United States

Phone: 952-261-3216 | Fax:
 
Primary Practice Address 1750 GREEN CREST DR
VICTORIA, MN 55386-9400
United States

Phone: 952-261-3216 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalMN794