Provider Demographics
NPI:1154063568
Name:ZUBER, BRANDELYN
Entity Type:Individual
Prefix:
First Name:BRANDELYN
Middle Name:
Last Name:ZUBER
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 1:10115 JEFFREYS ST APT 2022
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7913
Mailing Address - Country:US
Mailing Address - Phone:727-455-9711
Mailing Address - Fax:
Practice Address - Street 1:10115 JEFFREYS ST APT 2022
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7913
Practice Address - Country:US
Practice Address - Phone:727-455-9711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician