Healthcare Provider Details

I. General information

NPI: 1962182329
Provider Name (Legal Business Name): HANNAH BRENKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4041 W SYLVANIA AVE STE 202
TOLEDO OH
43623-4464
US

IV. Provider business mailing address

4041 W SYLVANIA AVE STE 202
TOLEDO OH
43623-4464
US

V. Phone/Fax

Practice location:
  • Phone: 419-504-5624
  • Fax:
Mailing address:
  • Phone: 419-504-5624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406004
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: