Individual
GRETCHEN ANNE BRENES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2614
NC
103TA0700X
Adult Development & Aging Psychologist
Primary
2614
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045CT
BCBS
—
05
—
6000436
—
NC
01
—
98151
MEDCOST
—
Enumeration date
12/02/2005
Last updated
05/04/2017
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