Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4974 | MA |
Y | 103TC0700X | Clinical Psychologist | 4974 | MA |
NPI | 1003065293 |
---|---|
Provider Name | Robin Joy Renders |
First Address | Stockbridge, MA 01262-1342 |
Second Address | Stockbridge, MA 01262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2008 |
Last Update Date | 12/09/2008 |