Provider Demographics
NPI:1649334053
Name:RENZE-EILERS, JEAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:RENZE-EILERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 REGENCY PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-8506
Mailing Address - Country:US
Mailing Address - Phone:919-469-2800
Mailing Address - Fax:919-469-8294
Practice Address - Street 1:2000 REGENCY PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-8506
Practice Address - Country:US
Practice Address - Phone:919-469-2800
Practice Address - Fax:919-469-8294
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1515103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist