Individual
MIRANDA REINHARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LDN
Contact information
Practice address
925 WEST ST, PERU, IL 61354-2757
(815) 223-3300
Mailing address
925 WEST ST, PERU, IL 61354-2757
(815) 223-3300
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164005650
STATE OF IL LICENSE
IL
01
—
886495
CDR
—
Enumeration date
01/08/2019
Last updated
01/08/2019
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