Doctor Name: | MRS. BRITTANY RENAKER |
NPI Number: | 1053717645 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCA |
License Number: | KY-1831 |
Business Practice Address: | 1440 Old Bethel Church Rd. Monticello, KY - 42633 |
Business Phone Number: | 6063430203 |
Business Fax Number: | 6063430301 |
Mailing Address: | 1440 Old Bethel Church Rd., MONTICELLO |
State: | KY |
Postal Code: | 42633 |
Phone Number: | 6063430203 |
Fax Number: | 6063430301 |
NPI Enumeration Date: | 11/10/2014 |
NPI Last Update Date: | 11/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | KY-1831 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |