Provider Demographics
NPI:1184318099
Name:RENTZ, JESSE (PSYD)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:RENTZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CLAYTIE S.
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221
Mailing Address - Country:US
Mailing Address - Phone:610-937-1058
Mailing Address - Fax:
Practice Address - Street 1:100 CLAYTIE S.
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221
Practice Address - Country:US
Practice Address - Phone:610-937-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34134103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical