Provider Demographics
NPI:1629511050
Name:RENCH, KARLENE
Entity type:Individual
Prefix:
First Name:KARLENE
Middle Name:
Last Name:RENCH
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 1:129 N JEFFERY AVE
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:MI
Mailing Address - Zip Code:48847-1129
Mailing Address - Country:US
Mailing Address - Phone:989-436-2086
Mailing Address - Fax:
Practice Address - Street 1:2426 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-4723
Practice Address - Country:US
Practice Address - Phone:989-773-6918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-03
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7402000076106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst