Individual
AMANDA JANE RENNOLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
12247 STRATFORD DR, CLIVE, IA 50325-8147
(515) 393-6702
Mailing address
12247 STRATFORD DR, CLIVE, IA 50325-8147
(515) 393-6702
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1214
NE
101YM0800X
Mental Health Counselor
Primary
082255
IA
101YM0800X
Mental Health Counselor
10474
NE
Other
Enumeration date
12/29/2014
Last updated
12/27/2023
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