Provider Demographics
NPI:1598417156
Name:BRENNAN, MARLEEN DANIELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARLEEN
Middle Name:DANIELLE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 GILLESPIE DR
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-2224
Mailing Address - Country:US
Mailing Address - Phone:304-687-2741
Mailing Address - Fax:
Practice Address - Street 1:2912 GILLESPIE DR
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-2224
Practice Address - Country:US
Practice Address - Phone:304-687-2741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1507225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty