Provider Demographics
NPI:1215525316
Name:ADAIR, RENEE DAWN
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:DAWN
Last Name:ADAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 N HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:CRAIGSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24430-2108
Mailing Address - Country:US
Mailing Address - Phone:540-849-8960
Mailing Address - Fax:
Practice Address - Street 1:186 N HANCOCK ST
Practice Address - Street 2:
Practice Address - City:CRAIGSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24430-2108
Practice Address - Country:US
Practice Address - Phone:540-849-8960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001683103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst