Individual
BRANDY M ROANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
36377
TX
103TC0700X
Clinical Psychologist
Primary
36377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308469101
—
TX
01
—
88610A
BCBS
TX
Enumeration date
08/10/2012
Last updated
04/12/2026
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