Most Relevant Information
Provider Data
| NPI Number: | 1003239641 |
| Provider Name: | RENEICE JOHNTINE CHARLES MSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | ASW34852 |
Most Important Dates
| Enumeration Date: | 02/03/2014 |
| Last Updated: | 02/04/2014 |
Provider Practice Location
155 N OCCIDENTAL BLVD
LOS ANGELES
CA
900264641
Practice Location Phone/Fax
| Phone: | 2133812931 |
| Fax: | 2133858446 |
Provider Mailing Location
155 N OCCIDENTAL BLVD
LOS ANGELES
CA
900264641
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |