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Individual

COURTNEY RUTH RENNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW

Contact information

Practice address
12 N 64TH ST, BELLEVILLE, IL 62223-3809
(618) 877-4420
Mailing address
448 WYLIE DR, NORMAL, IL 61761-5405
(888) 924-3786

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.109779
IL

Other

Enumeration date
10/12/2023
Last updated
10/12/2023
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