Provider Demographics
NPI:1245584259
Name:BRENNAN, REBECCA (MA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E CHEYENNE RD STE 207
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-2535
Mailing Address - Country:US
Mailing Address - Phone:719-510-0624
Mailing Address - Fax:719-487-9074
Practice Address - Street 1:1235 LAKE PLAZA DR STE 125
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3581
Practice Address - Country:US
Practice Address - Phone:719-510-0624
Practice Address - Fax:719-576-0298
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist