Individual
SAM RENNEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, LADC
Contact information
Practice address
2200 1ST AVE S, MINNEAPOLIS, MN 55404-3401
(612) 235-4590
Mailing address
2200 1ST AVE S, MINNEAPOLIS, MN 55404-3401
(612) 235-4590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306080
MN
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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