Provider Demographics
NPI:1861603250
Name:BRENNAN-EDWARDS, JANET BRENNAN (MAC, LAC)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:BRENNAN
Last Name:BRENNAN-EDWARDS
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 GODSPEED RD
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-1303
Mailing Address - Country:US
Mailing Address - Phone:301-518-0711
Mailing Address - Fax:
Practice Address - Street 1:2110 PRIEST BRIDGE DR
Practice Address - Street 2:STE. 3
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2472
Practice Address - Country:US
Practice Address - Phone:410-721-8221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00869171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist