Individual
KYLE A. RENICHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12 UNION ST, ROCKLAND, ME 04841-2739
(207) 701-4402
(207) 701-4486
Mailing address
78 ATLANTIC PLACE, SOUTH PORTLAND, ME 04106-2316
(207) 842-6556
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC 8308
ME
Other
Enumeration date
08/25/2008
Last updated
12/07/2011
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