Provider Demographics
NPI:1265643399
Name:RENFRO, APRIL HEATHER (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:HEATHER
Last Name:RENFRO
Suffix:
Gender:F
Credentials:MA CCC-SLP
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 232
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:MT
Mailing Address - Zip Code:59421-0232
Mailing Address - Country:US
Mailing Address - Phone:406-468-4062
Mailing Address - Fax:
Practice Address - Street 1:500 15TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4324
Practice Address - Country:US
Practice Address - Phone:406-455-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist