Healthcare Provider Details

I. General information

NPI: 1205791894
Provider Name (Legal Business Name): MRS. MELANIE ANGELINA DRENNEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 FOOTHILLS MALL DR
MARYVILLE TN
37801-5515
US

IV. Provider business mailing address

168 OSPREY CIR
VONORE TN
37885-2057
US

V. Phone/Fax

Practice location:
  • Phone: 865-385-0161
  • Fax:
Mailing address:
  • Phone: 865-385-0161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7718
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: