Healthcare Provider Details

I. General information

NPI: 1588508451
Provider Name (Legal Business Name): HARLEIGH JESS BRENNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 E 41ST TER
KANSAS CITY MO
64133-1448
US

IV. Provider business mailing address

427 E BOOKER ST
MARCELINE MO
64658-1630
US

V. Phone/Fax

Practice location:
  • Phone: 816-531-0045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: