Provider Demographics
NPI:1407440803
Name:PALMER, RENEE (LMHC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PALMER
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 1:27790 HAROLD ST
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-9012
Mailing Address - Country:US
Mailing Address - Phone:407-312-7340
Mailing Address - Fax:
Practice Address - Street 1:27790 HAROLD ST
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-9012
Practice Address - Country:US
Practice Address - Phone:407-312-7340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health