| Doctor Name: | MICHAEL L. RENNER |
| NPI Number: | 1669619904 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LIMHP |
| License Number: | 1020 |
| Business Practice Address: | 1212 Ivy Ave Ste 2 Crete, NE - 683332301 |
| Business Phone Number: | 4028262000 |
| Business Fax Number: | 4028262655 |
| Mailing Address: | Po Box 326, CRETE |
| State: | NE |
| Postal Code: | 683330326 |
| Phone Number: | 4028262000 |
| Fax Number: | 4028262655 |
| NPI Enumeration Date: | 01/08/2009 |
| NPI Last Update Date: | 08/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |