Individual
MS. BRANDI DANIELLE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA-MFT, LMFT
Contact information
Practice address
17 E GENESEE ST STE 1, AUBURN, NY 13021-4068
(315) 253-9795
(315) 253-3255
Mailing address
6018 DUNNING AVE, AUBURN, NY 13021-9823
(210) 291-7150
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0009181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181231501
—
TX
Enumeration date
01/30/2007
Last updated
01/30/2020
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