Provider Demographics
NPI:1083821482
Name:PENNETT, HELENE DEBORAH-LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:HELENE
Middle Name:DEBORAH-LYNNE
Last Name:PENNETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6007 MEADOWHILL DR
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5222
Mailing Address - Country:US
Mailing Address - Phone:817-919-5728
Mailing Address - Fax:
Practice Address - Street 1:700 NE LOOP 820
Practice Address - Street 2:SUITE 201
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76053-4634
Practice Address - Country:US
Practice Address - Phone:817-595-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24239103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent