Provider Demographics
NPI:1255462388
Name:KRUL, BRENDA ANN (MSSA, LISW)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:ANN
Last Name:KRUL
Suffix:
Gender:F
Credentials:MSSA, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12104 WILLARD AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-3618
Mailing Address - Country:US
Mailing Address - Phone:216-663-2024
Mailing Address - Fax:
Practice Address - Street 1:5706 TURNEY RD
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-3971
Practice Address - Country:US
Practice Address - Phone:216-518-9271
Practice Address - Fax:216-518-9298
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00097611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical