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Individual

COURTNEY M RENNICKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
136 E 57TH ST, SUITE 1101, NEW YORK, NY 10022-2707
(212) 308-2440
Mailing address
136 E 57TH ST, SUITE 1101, NEW YORK, NY 10022-2707
(212) 308-2440

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
017456
NY
103TC0700X
Clinical Psychologist
Primary
017456
NY
103TC2200X
Clinical Child & Adolescent Psychologist
017456
NY

Other

Enumeration date
12/10/2007
Last updated
12/10/2007
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