Provider Demographics
NPI:1982103875
Name:RENTROP, SAVANNAH ADELINE
Entity Type:Individual
Prefix:MS
First Name:SAVANNAH
Middle Name:ADELINE
Last Name:RENTROP
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 1:801 OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3711
Mailing Address - Country:US
Mailing Address - Phone:706-572-6031
Mailing Address - Fax:
Practice Address - Street 1:801 OAKHURST DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3711
Practice Address - Country:US
Practice Address - Phone:706-572-6031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician