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Individual
MISS RENITA ANN BIRT
Active
Individual
MISS RENITA ANN BIRT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, QMHP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
347C00000X
Private Vehicle
—
NULL
372600000X
Adult Companion
—
NULL
376J00000X
Homemaker
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474579189001
—
IL
Enumeration date
09/03/2019
Last updated
06/30/2022
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