Provider Demographics
NPI:1659812436
Name:MUNOZ, RENEE (CHEMICAL DEPENDENCY)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:CHEMICAL DEPENDENCY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4138
Mailing Address - Country:US
Mailing Address - Phone:253-383-7710
Mailing Address - Fax:253-383-8834
Practice Address - Street 1:712 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-273-2576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management