Provider Demographics
NPI:1992072656
Name:CHRISTNER-RENFROE, TRINA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:TRINA
Middle Name:L
Last Name:CHRISTNER-RENFROE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:CHATTAHOOCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:32324-1000
Mailing Address - Country:US
Mailing Address - Phone:850-663-7706
Mailing Address - Fax:850-663-7011
Practice Address - Street 1:119 E. WASHINGTON FLORIDA STATE HOSPITAL,
Practice Address - Street 2:BUILDING 1214, LANDIS HALL, ROOM 1090
Practice Address - City:CHATTAHOOCHEE
Practice Address - State:FL
Practice Address - Zip Code:32324-1000
Practice Address - Country:US
Practice Address - Phone:850-663-7706
Practice Address - Fax:850-663-7011
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6564174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist