Provider Demographics
NPI:1811562119
Name:PITRE, RENEE (PHD, RDT, BCT, LPC)
Entity Type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:PITRE
Suffix:
Gender:F
Credentials:PHD, RDT, BCT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 FLANDERS ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2008
Mailing Address - Country:US
Mailing Address - Phone:203-936-7850
Mailing Address - Fax:
Practice Address - Street 1:19 EDWARDS ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3913
Practice Address - Country:US
Practice Address - Phone:203-936-7850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3704