| Doctor Name: | DR. PHYLLIS REAMS BRENTZEL |
| NPI Number: | 1093783607 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY. D. |
| License Number: | PS008841L |
| Business Practice Address: | 12320 Route 30 Suites 4 & 6 North Huntingdon, PA - 156421872 |
| Business Phone Number: | 7248636488 |
| Business Fax Number: | 7248636488 |
| Mailing Address: | 4480 Pine Hollow Rd, TRAFFORD |
| State: | PA |
| Postal Code: | 150859529 |
| Phone Number: | 7248636488 |
| Fax Number: | 7248636488 |
| NPI Enumeration Date: | 03/09/2006 |
| NPI Last Update Date: | 07/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PS008841L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |