Provider Demographics
NPI:1134888357
Name:CAGLE, RENEE ANN (LPC-A)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:ANN
Last Name:CAGLE
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 WALNUT SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5391
Mailing Address - Country:US
Mailing Address - Phone:630-335-3256
Mailing Address - Fax:
Practice Address - Street 1:1817 WALNUT SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5391
Practice Address - Country:US
Practice Address - Phone:630-335-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional