Provider Demographics
NPI:1922345453
Name:VANZO, RENA JEAN (MS, LCGC)
Entity type:Individual
Prefix:
First Name:RENA
Middle Name:JEAN
Last Name:VANZO
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10927 S WOOD STONE CR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095
Mailing Address - Country:US
Mailing Address - Phone:217-313-0746
Mailing Address - Fax:801-453-6810
Practice Address - Street 1:10927 S WOOD STONE CR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:866-747-2662
Practice Address - Fax:801-453-6810
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7044096-3601170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS