Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | P.08143 | OH |
N | 2080P0006X | Developmental - Behavioral Pediatrician | P.08143 | OH |
NPI | 1013326305 |
---|---|
Provider Name | Sarah Brenner |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2014 |
Last Update Date | 12/10/2021 |