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Individual

SHASTA BRENSKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
4815 LIST DR STE 107, COLORADO SPRINGS, CO 80919-3340
(719) 325-6311
(844) 278-5902
Mailing address
104 W OLD BROADMOOR RD, COLORADO SPRINGS, CO 80906-3336
(214) 901-4196

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-07-3748
CO

Other

Enumeration date
05/07/2014
Last updated
02/02/2021
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