Individual
MRS. JEAN BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
70 BARKER ST, BUFFALO, NY 14209-2013
(716) 883-1914
(716) 883-7637
Mailing address
70 BARKER ST, BUFFALO, NY 14209-2013
(716) 883-1914
(176) 883-7637
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
063615
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000511966001
OTHER
NY
Enumeration date
08/01/2006
Last updated
12/11/2008
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