Provider Demographics
NPI:1689315152
Name:HURRIGAN, RENITA ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:RENITA
Middle Name:ELIZABETH
Last Name:HURRIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 RED FERN RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-1245
Mailing Address - Country:US
Mailing Address - Phone:502-408-2217
Mailing Address - Fax:
Practice Address - Street 1:4811 RED FERN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-1245
Practice Address - Country:US
Practice Address - Phone:502-408-2217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY285990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist