Provider Demographics
NPI:1619760352
Name:RENNHOFF, LILY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:RENNHOFF
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 HARWOOD RD STE 215
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4100
Mailing Address - Country:US
Mailing Address - Phone:817-393-7740
Mailing Address - Fax:682-334-7510
Practice Address - Street 1:217 HARWOOD RD STE 215
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4100
Practice Address - Country:US
Practice Address - Phone:817-393-7740
Practice Address - Fax:682-334-7510
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist