Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 2312 | CO |
Y | 103T00000X | Psychologist | 2312 | CO |
N | 103TR0400X | Rehabilitation Psychologist | 2312 | CO |
NPI | 1083680821 |
---|---|
Provider Name | Dr. Lisa Anne Brenner |
First Address | Denver, CO 80220-3808 |
Second Address | Denver, CO 80220-3808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 27/02/2017 |