Individual
MR. BEAU CHARLES BRENDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
255 S 17TH ST STE 1010, PHILADELPHIA, PA 19103-6210
(672) 319-5882
Mailing address
815 S 2ND ST, PHILADELPHIA, PA 19147-3415
(267) 231-9588
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC006129
PA
103T00000X
Psychologist
Primary
PS018603
PA
Other
Enumeration date
11/15/2011
Last updated
09/25/2018
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