Provider Demographics
NPI:1952026668
Name:BRUCE, RENAE H (LPC)
Entity Type:Individual
Prefix:MS
First Name:RENAE
Middle Name:H
Last Name:BRUCE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:RENAE
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1204 BENT OAKS CT STE 200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8000
Mailing Address - Country:US
Mailing Address - Phone:940-453-4773
Mailing Address - Fax:
Practice Address - Street 1:1204 BENT OAKS CT STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-8000
Practice Address - Country:US
Practice Address - Phone:940-320-9172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional