Individual
MARY BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FORT CAMPBELL, KY 42223-5349
(270) 798-8400
(270) 956-0180
Mailing address
BLANCHFIELD ARMY COMMUNITY HOSPITAL, 650 JOEL DRIVE, FORT CAMPBELL, KY 42223-5349
(270) 798-8400
(270) 956-0180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1016
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VAD000
UPIN
KY
Enumeration date
02/11/2008
Last updated
02/11/2008
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