Basic Information
| Provider Information | |||||||||
| NPI: | 1467875104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REICHERT | ||||||||
| FirstName: | SARA | ||||||||
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| Credential: | MPH MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 347 SMITH AVE N | ||||||||
| Address2: | GARDEN VIEW MEDICAL BUILDING 3RD FLOOR | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551022387 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512206159 | ||||||||
| FaxNumber: | 6128136360 | ||||||||
| Practice Location | |||||||||
| Address1: | 347 SMITH AVE N | ||||||||
| Address2: | GARDEN VIEW MEDICAL BUILDING 3RD FLOOR | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551022387 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512206159 | ||||||||
| FaxNumber: | 6128136360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2014 | ||||||||
| LastUpdateDate: | 10/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.