Provider Demographics
NPI:1104136043
Name:STINSON, REN F (PHD)
Entity type:Individual
Prefix:
First Name:REN
Middle Name:F
Last Name:STINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 WESTLAWN S
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1102
Mailing Address - Country:US
Mailing Address - Phone:319-335-7294
Mailing Address - Fax:319-335-7298
Practice Address - Street 1:3223 WESTLAWN S
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1102
Practice Address - Country:US
Practice Address - Phone:319-335-7294
Practice Address - Fax:319-335-7298
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0069468Medicaid