Individual
BRANDEE MASSENGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9650 ZELZAH AVE, NORTHRIDGE, CA 91325-2003
(818) 993-9311
Mailing address
9650 ZELZAH AVE, NORTHRIDGE, CA 91325-2003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1452791221
CA
104100000X
Social Worker
Primary
ASW123487
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
01/08/2018
Last updated
06/28/2024
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