Provider Demographics
NPI:1265805766
Name:RINNA, MEREDITH MARIE (LISW-SUPV)
Entity type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:MARIE
Last Name:RINNA
Suffix:
Gender:F
Credentials:LISW-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W FRONT ST UNIT 2470
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-7803
Mailing Address - Country:US
Mailing Address - Phone:734-344-7432
Mailing Address - Fax:734-344-7431
Practice Address - Street 1:1645 N DIXIE HWY STE 2
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-5231
Practice Address - Country:US
Practice Address - Phone:734-344-7432
Practice Address - Fax:734-344-7431
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0009722-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical