Provider Demographics
NPI:1134896657
Name:BREHENY, THERESA MARIE
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:BREHENY
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 1:49 CLEMENTS PL
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1010
Mailing Address - Country:US
Mailing Address - Phone:914-320-4190
Mailing Address - Fax:
Practice Address - Street 1:49 CLEMENTS PL
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1010
Practice Address - Country:US
Practice Address - Phone:914-320-4190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-24
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist