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General NPI Number Information
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NPI Number | 1245584259
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Entity Type | Individual
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Provider Name | REBECCA BRENNAN M.A.
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Gender | Female
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 1235 LAKE PLAZA DR STE 125
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-3581
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Country | US
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Telephone | 719-510-0624
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Fax | 719-576-0298
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Provider Business Mailing Address
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Address Line | 108 E CHEYENNE RD STE 207
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City | COLORADO SPRINGS
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State | CO
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Zip | 80906-2535
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Country | US
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Telephone | 719-510-0624
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Fax | 719-487-9074
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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