Individual
MR. ANTHONY M RENELLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LISAC
Contact information
Practice address
8171 E INDIAN BEND RD STE 101, SCOTTSDALE, AZ 85250-4830
(800) 922-0094
Mailing address
8540 E MCDOWELL RD UNIT 60, MESA, AZ 85207-1431
(480) 606-8602
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC15189
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084266
—
AZ
Enumeration date
05/31/2018
Last updated
09/19/2022
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