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General NPI Number Information
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NPI Number | 1174952378
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Entity Type | Individual
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Provider Name | MARY BRENNAN MA, MS, PHD
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Gender | Female
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 459 PATTERSON RD # 116
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City | HONOLULU
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State | HI
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Zip | 96819-1522
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Country | US
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Telephone | 808-433-0660
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Fax |
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Provider Business Mailing Address
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Address Line | 710 WANAAO PL
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City | KAILUA
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State | HI
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Zip | 96734-3551
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Country | US
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Telephone | 858-414-9738
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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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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0006055
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY-2191-0
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License Number State | HI
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