Provider Demographics
NPI:1053532952
Name:BRENN, JENNIFER ANN (LMFT, LADC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:BRENN
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SATELLITE DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-9329
Mailing Address - Country:US
Mailing Address - Phone:775-224-1373
Mailing Address - Fax:
Practice Address - Street 1:85 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3432
Practice Address - Country:US
Practice Address - Phone:775-324-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0915106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist