Individual
MRS. RANDIE BAUMAN-RENNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
112 FRANKLIN PL, WOODMERE, NY 11598-1217
(516) 374-3671
(516) 374-7864
Mailing address
112 FRANKLIN PL, WOODMERE, NY 11598-1217
(516) 374-3671
(516) 374-7864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
083139
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01880051
—
NY
Enumeration date
09/16/2015
Last updated
09/15/2020
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