Provider Demographics
NPI:1659269959
Name:KLINGER, BRENNA A
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:A
Last Name:KLINGER
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 1:320 N 490 W APT 5045
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-3699
Mailing Address - Country:US
Mailing Address - Phone:484-793-3022
Mailing Address - Fax:
Practice Address - Street 1:5899 W RIVENDELL DR # NA
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84081-6500
Practice Address - Country:US
Practice Address - Phone:801-304-7115
Practice Address - Fax:801-304-7115
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13198826-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical