Individual
AERIEL BRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QASP
Contact information
Practice address
10175 FORTUNE PKWY UNIT 903, SUITE 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Mailing address
1800 W BIG BEAVER RD STE 150, TROY, MI 48084-3535
(248) 918-5600
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-15-05021
—
Other
Enumeration date
12/06/2016
Last updated
07/21/2022
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