Provider Demographics
NPI:1851135578
Name:GRONER, BRENDA (MSED BCBA)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:GRONER
Suffix:
Gender:F
Credentials:MSED BCBA
Other - Prefix:MRS
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1331 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4695
Mailing Address - Country:US
Mailing Address - Phone:718-635-0795
Mailing Address - Fax:
Practice Address - Street 1:822 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5606
Practice Address - Country:US
Practice Address - Phone:718-942-3666
Practice Address - Fax:718-306-9726
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-24-72593103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst