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General NPI Number Information
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NPI Number | 1144954637
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Entity Type | Individual
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Provider Name | MS. EMILY CLAIRE BRENNAN
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 521 S LA GRANGE RD STE 201
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City | LA GRANGE
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State | IL
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Zip | 60525-5633
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Country | US
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Telephone | 312-741-3218
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Fax | 773-233-6111
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Provider Business Mailing Address
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Address Line | 731 MONTICELLO PL
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City | EVANSTON
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State | IL
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Zip | 60201-1745
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Country | US
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Telephone | 616-240-3347
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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