Individual
EMILY ELYSE BRENNECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4957
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-4957
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002690A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IN
Enumeration date
07/03/2019
Last updated
02/23/2024
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