Provider Demographics
NPI:1659689842
Name:KLAUTKY, RENEE CHRISTINE (PHD CDMS CLCP LSW)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:CHRISTINE
Last Name:KLAUTKY
Suffix:
Gender:F
Credentials:PHD CDMS CLCP LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8173 LONG ROAD
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110
Mailing Address - Country:US
Mailing Address - Phone:614-633-6895
Mailing Address - Fax:855-633-6895
Practice Address - Street 1:1209 HILL RD N # 204
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-8888
Practice Address - Country:US
Practice Address - Phone:614-633-6895
Practice Address - Fax:855-633-6895
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0029282171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator