Provider Demographics
NPI:1003690991
Name:BRANDT, MELANY
Entity Type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:BRANDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 NW 9TH STREET CIR APT 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5127
Mailing Address - Country:US
Mailing Address - Phone:305-205-3809
Mailing Address - Fax:
Practice Address - Street 1:10020 NW 9TH STREET CIR APT 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-5127
Practice Address - Country:US
Practice Address - Phone:305-205-3809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician