Provider Demographics
NPI:1386378784
Name:BREMNER, ALYSSA A
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:A
Last Name:BREMNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:M
Other - Last Name:BREMNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:3300 AUBURN RD STE 208
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-4001
Mailing Address - Country:US
Mailing Address - Phone:248-289-1894
Mailing Address - Fax:
Practice Address - Street 1:3300 AUBURN RD STE 208
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-4001
Practice Address - Country:US
Practice Address - Phone:248-289-1894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017398101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional