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1114630084
MIRANDA M RENNER
APPLETON, WI
NPI
1114630084
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 20113-130)
Enumeration Date
2023-01-05
Last Update Date
2023-01-05
Business Address
MIRANDA M RENNER SAC-IT
3301 N BALLARD RD STE B
APPLETON, WI 54911-9002
Phone number: 920-733-4443
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Mailing Address
MIRANDA M RENNER SAC-IT
3301 N BALLARD RD STE B
APPLETON, WI 54911-9002
Phone number: 920-733-4443
Copy
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