Healthcare Provider Details

I. General information

NPI: 1245151349
Provider Name (Legal Business Name): CHRISTINE BRENNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1023 POST RD
WARWICK RI
02888-3363
US

IV. Provider business mailing address

PO BOX 397
ALBION RI
02802-0397
US

V. Phone/Fax

Practice location:
  • Phone: 401-773-7116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMHC02031
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: