Individual
JENNIFER RENFROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-0385
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(228) 376-0385
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4511
LA
101YP2500X
Professional Counselor
Primary
2707
MS
101YP2500X
Professional Counselor
LPC.0016437
CO
Other
Enumeration date
02/23/2021
Last updated
07/16/2024
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