Provider Demographics
NPI:1053851139
Name:PINDELL, BRE MCCALL
Entity Type:Individual
Prefix:
First Name:BRE
Middle Name:MCCALL
Last Name:PINDELL
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 1:1264 E 113TH AVE
Mailing Address - Street 2:APT 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-1984
Mailing Address - Country:US
Mailing Address - Phone:443-413-2697
Mailing Address - Fax:
Practice Address - Street 1:1264 E 113TH AVE
Practice Address - Street 2:APT 101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-1984
Practice Address - Country:US
Practice Address - Phone:443-413-2697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician