Doctor Name: | RENEE PAGNUCCO |
NPI Number: | 1225444904 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | C1000380 |
Business Practice Address: | 964 N Market St Lisbon, OH - 444329363 |
Business Phone Number: | 3304241468 |
Business Fax Number: | |
Mailing Address: | Po Box 464, LISBON |
State: | OH |
Postal Code: | 444320464 |
Phone Number: | 3304241468 |
Fax Number: | 3304249844 |
NPI Enumeration Date: | 07/02/2014 |
NPI Last Update Date: | 07/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C1000380 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |