Individual
BRENDA MANDILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 AMBERWOOD DR, WINCHESTER, MA 01890-2202
(617) 763-7410
Mailing address
18 AMBERWOOD DR, WINCHESTER, MA 01890-2202
(617) 763-7410
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1029525
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029525
STATE OF MA LICENSE
MA
Enumeration date
01/10/2019
Last updated
01/10/2019
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