Provider Demographics
NPI:1003529231
Name:BRANDON, BRIANNA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:M
Last Name:BRANDON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2380 TAPESTRY PARK DR APT 303
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-0179
Mailing Address - Country:US
Mailing Address - Phone:321-626-5720
Mailing Address - Fax:
Practice Address - Street 1:2380 TAPESTRY PARK DR APT 303
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-0179
Practice Address - Country:US
Practice Address - Phone:321-626-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY11726103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist