Individual
MS. RENA BETH KORNBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCAT, BC-DMT, DTRL
Contact information
Practice address
16 N HANCOCK ST, MADISON, WI 53703-2802
(608) 251-0908
(608) 251-0939
Mailing address
16 N HANCOCK ST, MADISON, WI 53703-2802
(608) 251-0908
(608) 251-0939
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2-37
WI
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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