Individual
MRS. BRENDA JOY MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
627 S PALESTINE ST, ATHENS, TX 75751-3355
(903) 245-4379
(903) 852-4286
Mailing address
PO BOX 130011, TYLER, TX 75713-0011
(903) 245-4379
(903) 852-4286
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
30242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181212501
—
TX
Enumeration date
12/27/2006
Last updated
07/09/2007
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