Provider Demographics
NPI:1073894630
Name:RATTRAY, RENEE LYNN (LMHC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:LYNN
Last Name:RATTRAY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405-1913
Mailing Address - Country:US
Mailing Address - Phone:561-445-5007
Mailing Address - Fax:
Practice Address - Street 1:217.5 GREENWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405
Practice Address - Country:US
Practice Address - Phone:561-445-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health