Individual
DR. RENEE MARIE PENTICOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1818 WOODDALE DR, SUITE 204, WOODBURY, MN 55125-2940
(651) 255-6678
(651) 501-6091
Mailing address
PO BOX 25334, WOODBURY, MN 55125-0334
(651) 255-6678
(651) 501-6091
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 4060
MN
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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