Individual provider · Type 1 NPI

Ivory Tierra Renthrope Iii

Mental Health Counselor · Melbourne, FL

NPI number 1932546983 Active

Practice location

3270 Suntree Blvd
Melbourne, FL 32940-7530

Call (321) 610-7949 Map

Mailing address

3780 Erie St
Cocoa, FL 32926-3837

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Case Manager/Care Coordinator 171M00000XNone listed

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About NPI 1932546983

Ivory Tierra Renthrope Iii's National Provider Identifier is 1932546983, issued on May 31, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Melbourne, FL. The record was last updated on May 31, 2013.