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1205212453
TRACY RENDERMAN
WISCONSIN RAPIDS, WI
NPI
1205212453
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: 101YA0400X)
Enumeration Date
2015-08-10
Last Update Date
2015-08-10
Business Address
-- TRACY RENDERMAN SAC, IDP
2611 12TH ST S
WISCONSIN RAPIDS, WI 54494-6445
Phone number: 715-421-8869
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Mailing Address
-- TRACY RENDERMAN SAC, IDP
2611 12TH ST S
WISCONSIN RAPIDS, WI 54494-6445
Phone number: 715-694-2188
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