Individual
BRANDON CANELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
80 S CLINTON AVE APT 9B, BAY SHORE, NY 11706-8640
(631) 796-3185
Mailing address
496 SMITHTOWN BYP STE 203, SMITHTOWN, NY 11787-5011
(631) 496-0078
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
110221-01
NY
Other
Enumeration date
09/11/2020
Last updated
06/25/2021
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