Provider Demographics
NPI:1932438355
Name:BRENNAN, EILEEN DOROTHY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:DOROTHY
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 PROSPECT HILL RD
Mailing Address - Street 2:
Mailing Address - City:HUGUENOT
Mailing Address - State:NY
Mailing Address - Zip Code:12746-5126
Mailing Address - Country:US
Mailing Address - Phone:845-725-7986
Mailing Address - Fax:
Practice Address - Street 1:691 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:HUGUENOT
Practice Address - State:NY
Practice Address - Zip Code:12746-5126
Practice Address - Country:US
Practice Address - Phone:845-725-7986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013048-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist