Gearhart, Renee L

Gearhart, Renee L is an sole proprietor health care provider with primary practice located at 1453 N. Main Street Suite F, San Luis AZ 85349. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Gearhart, Renee L can be contacted via phone (928) 627-6567.

Contact Information

Primary practice address
1453 N. Main Street Suite F San Luis AZ 85349
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X Arizona

Profile Details

NPI number 1760501506
LBN Legal business name Gearhart, Renee L
Credentials M.ED. N.C.C.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 29th, 2007
Last updated Jul 26th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760501506 NPPES
Arizona Other 838162 AHCCCS

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