Provider Demographics
NPI:1437434768
Name:MARENTETTE, ELIZABETH (LLPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MARENTETTE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:ALBU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLPC
Mailing Address - Street 1:850 W UNIVERSITY DR STE C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1845
Mailing Address - Country:US
Mailing Address - Phone:586-855-1356
Mailing Address - Fax:
Practice Address - Street 1:850 W UNIVERSITY DR STE C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1852
Practice Address - Country:US
Practice Address - Phone:586-855-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health