Individual
DR. TERRY J BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
9355 JORNADA LN APT 6, ATASCADERO, CA 93422-5859
(503) 999-9894
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2083
OR
Other
Enumeration date
09/25/2010
Last updated
09/25/2010
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