| Doctor Name: | MS. ELAINE DOTY RENFRO |
| NPI Number: | 1073786844 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LSCSW , LCSW |
| License Number: | 2007000625 |
| Business Practice Address: | 920 6th Ave Leavenworth, KS - 660483225 |
| Business Phone Number: | 9136827225 |
| Business Fax Number: | |
| Mailing Address: | 17491 166th St, BONNER SPRINGS |
| State: | KS |
| Postal Code: | 660127274 |
| Phone Number: | 9137243911 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2008 |
| NPI Last Update Date: | 04/11/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2007000625 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |