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Individual

BRENT PHILLIP BRENDLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S. L.P.C.

Contact information

Practice address
63 MAIN ST, SOUTHAMPTON, NJ 08088-8869
(609) 755-5680
Mailing address
PO BOX 2383, SOUTHAMPTON, NJ 08088-2383
(609) 755-5680

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00389500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0400526582
NJ
Enumeration date
05/31/2013
Last updated
05/31/2013
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