Provider Demographics
NPI:1346403805
Name:RHANEY, FENTON RENEE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:FENTON
Middle Name:RENEE
Last Name:RHANEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 NORTHSIDE RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8530
Mailing Address - Country:US
Mailing Address - Phone:252-771-5266
Mailing Address - Fax:
Practice Address - Street 1:200 W CONSTANCE RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-4413
Practice Address - Country:US
Practice Address - Phone:757-539-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-04
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000367225X00000X
NC0843225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist