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Individual
RENEE ANN VON PHELPS
Active
Individual
RENEE ANN VON PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161684
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0284130
—
OH
Enumeration date
05/14/2018
Last updated
02/03/2021
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