Individual
BRANDI NICOLE GWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
320 DALY STREET, SUITE 101, DUBOIS, PA 15801-1894
(814) 591-7595
Mailing address
345 MOUNTAIN RUN RD, DU BOIS, PA 15801-7033
(814) 591-7595
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW130024
PA
1041C0700X
Clinical Social Worker
Primary
CW020265
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102865065003
—
PA
Enumeration date
05/16/2007
Last updated
05/15/2021
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