Provider Demographics
NPI:1013547363
Name:WARREN, BRANDI MARIE (MASTERS DEGREE)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:MARIE
Last Name:WARREN
Suffix:
Gender:F
Credentials:MASTERS DEGREE
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:MARIE
Other - Last Name:DURGIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 27TH AVE STE 9&10
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-1315
Mailing Address - Country:US
Mailing Address - Phone:772-257-5264
Mailing Address - Fax:
Practice Address - Street 1:755 27TH AVE STE 9&10
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-1315
Practice Address - Country:US
Practice Address - Phone:772-257-5264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health