Individual
MRS. BRANDY NICOLE EDMISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2489 DIPLOMAT PKWY E, CAPE CORAL, FL 33909-5422
(239) 652-1800
(239) 652-1931
Mailing address
1800 NW 39TH AVE, CAPE CORAL, FL 33993-3505
(239) 691-4885
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW10290
FL
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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