Provider Demographics
NPI:1407110380
Name:BRENNAN, ERIN R (CPRP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:R
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 W BURNSVILLE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2524
Mailing Address - Country:US
Mailing Address - Phone:952-564-3000
Mailing Address - Fax:952-847-4966
Practice Address - Street 1:151 W BURNSVILLE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2524
Practice Address - Country:US
Practice Address - Phone:952-564-3000
Practice Address - Fax:952-847-4966
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2054860101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor