Individual
MS. ANN SUSAN BRENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MARRIAGE AND FAMILY
Contact information
Practice address
31 WOODS GROVE RD, WESTPORT, CT 06880-2427
(203) 226-0464
(203) 226-0464
Mailing address
31 WOODS GROVE RD, WESTPORT, CT 06880-2427
(203) 226-0464
(203) 226-0464
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
000432-1
NY
106H00000X
Marriage & Family Therapist
Primary
000486
CT
106H00000X
Marriage & Family Therapist
MFC15135
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11561882
CAQH
CT
01
—
410000486CT01
ANTHEM BLUE CROSS
CT
Enumeration date
08/02/2006
Last updated
07/08/2007
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