Individual
MRS. JAMIE LYNN RENARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CSAC
Contact information
Practice address
23 W. SCOTT ST., FOND DU LAC, WI 54935
(920) 926-0101
(920) 926-0060
Mailing address
23 W. SCOTT ST., FOND DU LAC, WI 54935
(920) 926-0101
(920) 926-0060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15531130
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100013805
—
WI
Enumeration date
07/29/2008
Last updated
05/24/2016
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