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General NPI Number Information
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NPI Number | 1033221536
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Entity Type | Organization
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Legal Business Name | RENEW PSYCHOLOGICAL SERVICES INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 72 VILLAGE WAY SUITE 1A
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City | HUDSON
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State | OH
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Zip | 44236-5109
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Country | US
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Telephone | 330-655-2674
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Fax | 330-650-2609
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Provider Business Mailing Address
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Address Line | 72 VILLAGE WAY SUITE 1A
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City | HUDSON
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State | OH
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Zip | 44236-5109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | REBECCA MCMORROW
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Credential | PH.D.
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Telephone | 330-655-2674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3940
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License Number State | OH
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