Individual
DR. MICHELE BRENNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
460 TOWN PLAZA AVE, SUITE 230, PONTE VEDRA, FL 32081-5139
(904) 671-6237
Mailing address
460 TOWN PLAZA AVE, SUITE 230, PONTE VEDRA, FL 32081-5139
(904) 671-6237
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
003326
GA
103T00000X
Psychologist
Primary
PY9335
FL
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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