Basic Information
| Provider Information | |||||||||
| NPI: | 1023356532 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RENNIE | ||||||||
| FirstName: | ROBYN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD, LPCC, NCC, RPTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1655 BURLINGTON PIKE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FLORENCE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410424909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593426444 | ||||||||
| FaxNumber: | 8593420999 | ||||||||
| Practice Location | |||||||||
| Address1: | 1655 BURLINGTON PIKE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FLORENCE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410424909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593426444 | ||||||||
| FaxNumber: | 8593420999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2013 | ||||||||
| LastUpdateDate: | 01/18/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 1414 | KY | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.