Organization
RENU 2 LLC
Active
Other names
RENU 2
Organization subpart
No
Provider details
NPI number
Authorized official
ESONIJA SHAVON FULGHAM (OWNER)
(202) 494-6119
Entity
Organization
Contact information
Practice address
8010 BLAIR MILL WAY APT 207E, SILVER SPRING, MD 20910-6805
(202) 494-6119
Mailing address
8010 BLAIR MILL WAY APT 207E, SILVER SPRING, MD 20910-6805
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2022
Last updated
07/14/2023
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