Provider Demographics
NPI:1013691005
Name:JEREZ, BRINNETTE (MA)
Entity Type:Individual
Prefix:
First Name:BRINNETTE
Middle Name:
Last Name:JEREZ
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 1:353 E 83RD ST APT 21J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4342
Mailing Address - Country:US
Mailing Address - Phone:347-881-4468
Mailing Address - Fax:
Practice Address - Street 1:353 E 83RD ST APT 21J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4342
Practice Address - Country:US
Practice Address - Phone:347-881-4468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist