Individual
CHRISTINE ANN RENUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8998 LANE LORAINE, ROGERS, AR 72756-7891
(479) 366-2846
Mailing address
3310 OAK VISTA DRIVE, PORT ORANGE, FL 32128
(479) 354-2455
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2420C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
06/15/2011
Last updated
12/20/2021
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