Provider Demographics
NPI:1083804348
Name:DRENNER, DAMONTE
Entity Type:Individual
Prefix:
First Name:DAMONTE
Middle Name:
Last Name:DRENNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8023 CHIANTI DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5305
Mailing Address - Country:US
Mailing Address - Phone:321-663-4517
Mailing Address - Fax:407-909-9266
Practice Address - Street 1:8023 CHIANTI DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-5305
Practice Address - Country:US
Practice Address - Phone:321-663-4517
Practice Address - Fax:407-909-9266
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral