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General NPI Number Information
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NPI Number | 1447845284
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Entity Type | Individual
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Provider Name | ELENA J RENKEN PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 392 MERROW RD STE E
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City | TOLLAND
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State | CT
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Zip | 06084-3974
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Country | US
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Telephone | 860-830-7838
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Fax |
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Provider Business Mailing Address
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Address Line | 555 WINCHESTER AVE APT 7
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City | NEW HAVEN
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State | CT
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Zip | 06511-1978
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Country | US
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Telephone | 406-223-0221
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3981
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License Number State | CT
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