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Individual

SARAH E BRANDENBERGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CGC

Contact information

Practice address
11115 PARKVIEW PLAZA DR, ATTN: SARAH KING, FORT WAYNE, IN 46845-1701
(260) 266-8271
(260) 266-8271
Mailing address
3926 NEW VISION DR BLDG H, FORT WAYNE, IN 46845-1712
(260) 373-9728
(260) 458-5636

Taxonomy

Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
74000081A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123869
NATIONAL SOCIETY OF GENETIC COUNSELORS
IN
01
74000081A
PROFESSIONAL LICENSING AGENCY OF INDIANA
IN
Enumeration date
04/13/2015
Last updated
01/04/2017
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