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Individual

DR. EDWIN BRENNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD, LP

Contact information

Practice address
3353 UNIVERSITY PKWY, LEESVILLE, LA 71446-9041
(337) 392-3800
Mailing address
FORT POLK VA OUTPATIENT CLINIC, 3353 UNIVERSITY PARKWAY, LEESVILLE, LA 71446, LA 71446
(373) 392-3800

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401014593
MI
103TH0100X
Health Service Psychologist
1544
LA
103TH0100X
Health Service Psychologist
Primary

Other

Enumeration date
03/18/2016
Last updated
09/27/2022
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