Provider Demographics
NPI:1023001229
Name:CHRISTENSEN, BRANDON (MSW)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 94 BOX 1946
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09824-1901
Mailing Address - Country:TR
Mailing Address - Phone:322-316-6452
Mailing Address - Fax:
Practice Address - Street 1:PSC 94 BOX 1946
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09824-1901
Practice Address - Country:TR
Practice Address - Phone:322-316-6452
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20030069411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical