Provider Demographics
NPI:1093174385
Name:PLEDGURE, BRANDY (BSW, MSW STUDENT)
Entity Type:Individual
Prefix:MS
First Name:BRANDY
Middle Name:
Last Name:PLEDGURE
Suffix:
Gender:F
Credentials:BSW, MSW STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 VALERIE ARMS DR APT 403
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-2121
Mailing Address - Country:US
Mailing Address - Phone:937-260-4587
Mailing Address - Fax:
Practice Address - Street 1:3320 VALERIE ARMS DR APT 403
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-2121
Practice Address - Country:US
Practice Address - Phone:937-260-4587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1610035-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker