Provider Demographics
NPI:1013374578
Name:BRENNAN, BRITTANIA
Entity Type:Individual
Prefix:
First Name:BRITTANIA
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E SOUTH ST APT A
Mailing Address - Street 2:
Mailing Address - City:ELBURN
Mailing Address - State:IL
Mailing Address - Zip Code:60119-9009
Mailing Address - Country:US
Mailing Address - Phone:815-954-7825
Mailing Address - Fax:
Practice Address - Street 1:304 E SOUTH ST APT A
Practice Address - Street 2:
Practice Address - City:ELBURN
Practice Address - State:IL
Practice Address - Zip Code:60119-9009
Practice Address - Country:US
Practice Address - Phone:815-954-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker