Provider Demographics
NPI:1497886576
Name:BRENNER, ZOE DEE (LAC)
Entity type:Individual
Prefix:MS
First Name:ZOE
Middle Name:DEE
Last Name:BRENNER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6900 WISCONSIN AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6114
Mailing Address - Country:US
Mailing Address - Phone:301-718-0953
Mailing Address - Fax:301-961-5340
Practice Address - Street 1:6900 WISCONSIN AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6114
Practice Address - Country:US
Practice Address - Phone:301-718-0953
Practice Address - Fax:301-961-5340
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU118171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist