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General NPI Number Information
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NPI Number | 1538979406
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Entity Type | Organization
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Legal Business Name | RENATA DRUKH PSYCHOLOGY LLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 10163 MC LAURIN RD E
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6509
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Country | US
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Telephone | 847-293-8864
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Fax |
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Provider Business Mailing Address
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Address Line | 10163 MC LAURIN RD E
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6509
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Country | US
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Telephone | 847-293-8864
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RENATA DRUKH
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Credential |
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Telephone | 847-293-8864
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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 |
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License Number State |
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