Individual
MARY RENNEBOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
703 SE 1ST AVE, CANBY, OR 97013-3849
(503) 266-7686
(503) 266-7382
Mailing address
703 SE 1ST AVE, CANBY, OR 97013-3849
(503) 266-7686
(503) 266-7382
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
527846
OR
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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