Doctor Name: | RENADA RICHARDSON |
NPI Number: | 1114382819 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CACP-I |
License Number: | |
Business Practice Address: | 200 Calhoun St Winnsboro, SC - 291801508 |
Business Phone Number: | 8036352335 |
Business Fax Number: | 8036359665 |
Mailing Address: | 200 Calhoun St, WINNSBORO |
State: | SC |
Postal Code: | 291801508 |
Phone Number: | 8036352335 |
Fax Number: | 8036359665 |
NPI Enumeration Date: | 12/22/2015 |
NPI Last Update Date: | 12/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |