Provider Information for 1679202212
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RENAE CAMERON LCSW
Sex: Female
NPI: 1679202212
Last Updated: 2023-11-27
Certification Date: 2023-11-27
Certification Date: 2023-11-27
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1679202212 | ||||||||||||||
| Enumeration Date | 2022-06-08 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 250 N SHADELAND AVE INDIANAPOLIS, IN 46219-4959 United States Phone: | Fax: | ||||||||||||||
| Primary Practice Address | 350 S LANDMARK AVE BLOOMINGTON, IN 47403-5001 United States Phone: 812-332-9874 | Fax:812-335-7604 | ||||||||||||||
| Secondary Practice Address(es) | 3519 S KENNEDY DR | ||||||||||||||
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