Healthcare Provider Details

I. General information

NPI: 1528048741
Provider Name (Legal Business Name): RENEE MARY OURADNIK LLP- LIMITED LICENSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RENEE MARY LAPALM TLLP AND/OR LLP

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 N LINCOLN RD RM CB230
ESCANABA MI
49829-2510
US

IV. Provider business mailing address

2920 COLLEGE AVE
ESCANABA MI
49829-9597
US

V. Phone/Fax

Practice location:
  • Phone: 906-786-4797
  • Fax: 906-786-6762
Mailing address:
  • Phone: 906-786-4797
  • Fax: 906-786-6762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6361005743
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: