Individual
BRENNA A CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
200 N PATRICK BLVD STE 250, BROOKFIELD, WI 53045-5883
(888) 754-0398
Mailing address
7905 OLD AMISH RD, AMHERST, WI 54406-9190
(715) 347-3046
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
425-140
WI
Other
Enumeration date
04/08/2021
Last updated
08/05/2021
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