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NPI Code Detail

MEDICARE: DR. JANA RENTZEL PHD, CSD

MEDICARE: DR. JANA RENTZEL PHD, CSD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP1600XPastoral Counselor

General Provider Information

NPI Number : 1457990491
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANA RENTZEL PHD, CSD
Provider Business Mailing Address
First Line : 6705 DELOACHE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75225-2510
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6705 DELOACHE AVE
Second Line :
City : DALLAS
State : TX
Zip : 75225-2510
Country : US
Telephone Number : 972-489-9600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2019
Last Update Date : 12/21/2019

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