Brenneman, Jill Marie
Brenneman, Jill Marie is an individual health care provider with primary practice located at 445 E Dublin Granville Rd , Worthington OH 43085-3192. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Brenneman, Jill Marie can be contacted via phone (614) 436-7837.Contact Information
Primary practice address
445 E Dublin Granville Rd
Worthington OH 43085-3192
Phone: (614) 436-7837
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X |
Profile Details
| NPI number | 1619645157 |
|---|---|
| LBN Legal business name | Brenneman, Jill Marie |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2021 |
| Last updated | Jul 8th, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619645157 | NPPES |
| Ohio | MEDICAID | 010684796 |
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