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General NPI Number Information
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NPI Number | 1972703718
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Entity Type | Individual
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Provider Name | RENEE DAWN RIENECKE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | DENVER HEALTH AND HOSPITAL AUTHORITY 777 BANNOCK ST.
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City | DENVER
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State | CO
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Zip | 80204
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Country | US
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Telephone | 866-824-4306
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Fax |
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Provider Business Mailing Address
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Address Line | 3941 N WASHTENAW AVE
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City | CHICAGO
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State | IL
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Zip | 60618-5997
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Country | US
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Telephone | 773-497-6838
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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 | 071007132
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0006378
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License Number State | CO
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