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General NPI Number Information
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NPI Number | 1407074362
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Entity Type | Individual
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Provider Name | RENEE T KOLECKI PCC-S
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Gender | Female
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 14701 DETROIT AVE
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City | LAKEWOOD
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State | OH
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Zip | 44107-4115
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Country | US
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Telephone | 216-228-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 412 MUIRFIELD DR
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City | HIGHLAND HEIGHTS
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State | OH
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Zip | 44143-3636
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Country | US
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Telephone | 216-870-6672
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0004147
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License Number State | OH
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