Provider Demographics
NPI:1699905992
Name:BRENNAN, LAUREL (OT)
Entity type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-4450
Mailing Address - Country:US
Mailing Address - Phone:443-310-1706
Mailing Address - Fax:
Practice Address - Street 1:5955 QUINN ORCHARD RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-6656
Practice Address - Country:US
Practice Address - Phone:310-228-2249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06086225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist