Provider Demographics
NPI:1770869125
Name:STEEN, BRENDA LOUISE (RPH)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:LOUISE
Last Name:STEEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ANDREW DRIVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:CT
Mailing Address - Zip Code:06019-5001
Mailing Address - Country:US
Mailing Address - Phone:860-693-2090
Mailing Address - Fax:
Practice Address - Street 1:39 ANDREW DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:CT
Practice Address - Zip Code:06019-5001
Practice Address - Country:US
Practice Address - Phone:860-693-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist