Individual
MRS. BRENDA PEARL TENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
PRO 21845 1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067796
GHI
NY
05
—
01534716
—
NY
01
—
147468
VALUE OPTIONS
NY
Enumeration date
02/08/2007
Last updated
11/25/2014
Update your record
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