Individual
SUZANNE BRANDENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.A.D.C, L.C.P.C.
Contact information
Practice address
1214 LAVALE AVE, LAVALE, MD 21502-7516
(301) 697-7236
Mailing address
1214 LAVALE AVE, LAVALE, MD 21502-7516
(301) 697-7236
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC2332
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA392
MD
101YM0800X
Mental Health Counselor
LC2332
MD
101YP2500X
Professional Counselor
LC2332
MD
Other
Enumeration date
10/12/2009
Last updated
10/12/2009
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