NPI 1093255242

Cheryl Ann Renzulli, MALAT

Practitioner Addiction (Substance Use Disorder) Counselor Jackson, WY

Practice location

Address: 1115 Maple Way Suite C, Jackson, WY 83001-8567
Phone: (307) 699-0807
Fax: (307) 733-7339
Mailing address: PO Box 9615, Jackson, WY 83002-9615

Registered specialties

Addiction (Substance Use Disorder) Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence LAT #324 (WY)

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Registry record

NPI: 1093255242
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Mar 2017
Record last updated: 6 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.