Individual
JANE SUSANN BRENNEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
223 MAIN ST STE B, FESTUS, MO 63028-1952
(636) 249-9993
Mailing address
9928 THURMAN OAKS RD, VALLES MINES, MO 63087-1324
(636) 249-9993
(636) 243-3903
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2012024498
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013268911
—
MO
Enumeration date
10/02/2012
Last updated
11/01/2024
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