Overview
Name: CAROL RENNINGER LISW
Specialty: Mental Health Counselor
Type of Practice: Individual provider
Provider/Org:
Medical School:
Graduation year from medical school:
Affiliation:
Specialties
Practice Type: Behavioral Health & Social Service Providers
Classification: Counselor
Specialization: Mental Health.
Definition of Specialty: Definition to come…
License & NPI
License #(s): I05359, , , ,
License State(s): NM, , , ,
Addresses
Practice Location: 1960 N DATE ST,T OR C,NM,879013701,US
Mailing Address: 255 HWY 187,HATCH,NM,879370370,US
Contact #
Practice location phone #: 5052673088
Practice location fax #: 5052671747
Mailing address Phone #: 5052673088
Mailing Address fax #: 5052671747
Authorized official Name/Telephone #:
Misc
Date NPI was obtained: 08/25/2005
Last data data was updated: 07/08/2007
Insurances: