Provider Demographics
NPI:1558627505
Name:RENELT, ALEXANDER WENZEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:WENZEL
Last Name:RENELT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 EAST HOSPITAL ROAD
Mailing Address - Street 2:DEPARTMENT OF BEHAVIORAL HEALTH
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 STUART ST
Practice Address - Street 2:DEPARTMENT OF BEHAVIORAL HEALTH
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29207-5700
Practice Address - Country:US
Practice Address - Phone:803-751-2513
Practice Address - Fax:803-751-7811
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist