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NPI Code Detail

MEDICARE: RENEE ALEXANDRA KRESS

MEDICARE: RENEE ALEXANDRA KRESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.165869OH

General Provider Information

NPI Number : 1760970719
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENEE ALEXANDRA KRESS
Provider Business Mailing Address
First Line : 110 HIGHLAND AVE
Second Line :
City : CIRCLEVILLE
State : OH
Zip : 43113-1208
Country : US
Telephone Number : 740-477-2779
Fax Number :
Provider Business Practice Location Address
First Line : 327 E MILL ST
Second Line :
City : CIRCLEVILLE
State : OH
Zip : 43113-2029
Country : US
Telephone Number : 740-500-1402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2018
Last Update Date : 04/25/2018

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