Provider Demographics
NPI:1235847047
Name:CRESPO, BRANDI L
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:L
Last Name:CRESPO
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 1:655 E MAIN ST EXT
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-4429
Mailing Address - Country:US
Mailing Address - Phone:413-663-1667
Mailing Address - Fax:
Practice Address - Street 1:535 CURRAN HWY
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3901
Practice Address - Country:US
Practice Address - Phone:413-664-9345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician