Provider Demographics
NPI:1649799602
Name:PANARELLO, BRENNA PRIEST (DPT)
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:PRIEST
Last Name:PANARELLO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:BRENNA
Other - Middle Name:MARIE
Other - Last Name:PRIEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8120 WOODMONT AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2743
Mailing Address - Country:US
Mailing Address - Phone:301-229-9110
Mailing Address - Fax:301-355-0615
Practice Address - Street 1:8120 WOODMONT AVE STE 330
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2743
Practice Address - Country:US
Practice Address - Phone:301-229-9110
Practice Address - Fax:301-355-0615
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19528225100000X
MD27439225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist