Provider Demographics
NPI:1730399601
Name:REINARDY KRAGNESS, RENAE MARY (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:RENAE
Middle Name:MARY
Last Name:REINARDY KRAGNESS
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Gender:F
Credentials:PSYD, LP
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Mailing Address - Street 1:14525 HIGHWAY 7
Mailing Address - Street 2:SUITE 340
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3734
Mailing Address - Country:US
Mailing Address - Phone:952-367-4100
Mailing Address - Fax:952-377-2828
Practice Address - Street 1:14525 HIGHWAY 7
Practice Address - Street 2:SUITE 340
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3734
Practice Address - Country:US
Practice Address - Phone:952-367-4100
Practice Address - Fax:952-377-2828
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN4707103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist