Provider Demographics
NPI:1720732977
Name:BRENNAN, KATHERINE HOLLIS (MA)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:HOLLIS
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 17 RD
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-2494
Mailing Address - Country:US
Mailing Address - Phone:719-373-8868
Mailing Address - Fax:
Practice Address - Street 1:749 ROOD AVE
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3656
Practice Address - Country:US
Practice Address - Phone:970-458-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist