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General NPI Number Information
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NPI Number | 1902908585
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Entity Type | Individual
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Provider Name | SARA W BRENNER LICSW
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Gender | Female
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 440 LEXINGTON ST SUITES 3-4
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City | AUBURNDALE
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State | MA
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Zip | 02466-1923
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Country | US
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Telephone | 617-332-4121
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Fax |
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Provider Business Mailing Address
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Address Line | 355 LEXINGTON ST
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City | AUBURNDALE
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State | MA
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Zip | 02466-1211
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Country | US
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Telephone | 617-332-7908
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 104216
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License Number State | MA
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