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Individual
RENEA MICHELLE TIRRELL
Active
Individual
RENEA MICHELLE TIRRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0001272
CT
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004123840
—
CT
05
—
008017935
—
CT
05
—
008031626
—
CT
Enumeration date
04/03/2012
Last updated
03/28/2019
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