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Individual

BRYAN BRANDENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LPC

Contact information

Practice address
26731 W POINT MACKENZIE RD, WASILLA, AK 99623-8709
(907) 376-4534
(907) 376-3248
Mailing address
1630 N RIVER ROCK CIR, PALMER, AK 99645-9698
(907) 441-7392

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
102717
AK

Other

Enumeration date
08/01/2019
Last updated
01/10/2022
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