Individual
MRS. RENEE LOUISE DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
108 N MAIN ST, SUITE # 305, SOUTH BEND, IN 46601-1625
(574) 234-3515
(574) 234-3565
Mailing address
108 N MAIN ST, SUITE # 305, SOUTH BEND, IN 46601-1625
(574) 234-3515
(574) 234-3565
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IN
Other
Enumeration date
08/31/2007
Last updated
09/12/2007
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