Provider Demographics
NPI:1639239361
Name:RENCHNER, MICHELE R
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:R
Last Name:RENCHNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ALAMEDA PL
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1201
Mailing Address - Country:US
Mailing Address - Phone:914-665-2999
Mailing Address - Fax:914-665-2999
Practice Address - Street 1:22 ALAMEDA PL
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-1201
Practice Address - Country:US
Practice Address - Phone:914-665-2999
Practice Address - Fax:914-665-2999
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 02150103TC0700X
NY009237-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical