Individual
THEODORE RENWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC-T
Contact information
Practice address
116 JOHN ST FL 27, NEW YORK, NY 10038-3414
(212) 964-0128
(212) 964-0112
Mailing address
116 JOHN ST FL 27, NEW YORK, NY 10038-3414
(212) 964-0128
(212) 964-0112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25845
NY
Other
Enumeration date
04/15/2011
Last updated
04/15/2011
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