Provider Demographics
NPI:1184203598
Name:BRANDT, BETTY J
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:J
Last Name:BRANDT
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 1:1880 TOWNSHIP ROAD 378
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-6932
Mailing Address - Country:US
Mailing Address - Phone:174-042-4601
Mailing Address - Fax:
Practice Address - Street 1:1880 TOWNSHIP ROAD 378
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-6932
Practice Address - Country:US
Practice Address - Phone:740-424-6015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant