Provider Demographics
NPI:1184319139
Name:RENNAU, ELIZABETH (PLPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RENNAU
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MO
Mailing Address - Zip Code:65617-0617
Mailing Address - Country:US
Mailing Address - Phone:417-376-2238
Mailing Address - Fax:
Practice Address - Street 1:424 E NORTON RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65803-3638
Practice Address - Country:US
Practice Address - Phone:417-883-6809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023009068101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health