Individual
MS. CHERYL ANN RENZULLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LAT
Contact information
Practice address
1115 MAPLE WAY, SUITE C, JACKSON, WY 83001-8567
(307) 699-0807
(307) 733-7339
Mailing address
PO BOX 9615, JACKSON, WY 83002-9615
(307) 699-0807
(307) 733-7339
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAT #324
WY
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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