Doctor Name: | MR. RICK SCOTT BRENNER |
NPI Number: | 1043690191 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | OH1277534 |
Business Practice Address: | 90 N East St Pickerington, OH - 431471170 |
Business Phone Number: | 6149206162 |
Business Fax Number: | |
Mailing Address: | 7593 Lorimar Dr, REYNOLDSBURG |
State: | OH |
Postal Code: | 430688300 |
Phone Number: | 7409736784 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2015 |
NPI Last Update Date: | 06/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | OH1277534 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |