Provider Demographics
NPI:1689872210
Name:RENFRO, MARY-HANNA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY-HANNA
Middle Name:
Last Name:RENFRO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 LITCHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-6014
Mailing Address - Country:US
Mailing Address - Phone:713-465-8896
Mailing Address - Fax:
Practice Address - Street 1:75 LITCHFIELD LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-6014
Practice Address - Country:US
Practice Address - Phone:713-465-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14696OtherLICENSED PROFESSIONAL CON