Provider Demographics
NPI:1407491269
Name:BRANDNER, MARQUETTE A (MS, LPCMH, ACT, QMHP)
Entity Type:Individual
Prefix:
First Name:MARQUETTE
Middle Name:A
Last Name:BRANDNER
Suffix:
Gender:F
Credentials:MS, LPCMH, ACT, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 E ROSA PARKS PL APT 102
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3122
Mailing Address - Country:US
Mailing Address - Phone:605-646-2256
Mailing Address - Fax:
Practice Address - Street 1:5010 E ROSA PARKS PL APT 102
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3122
Practice Address - Country:US
Practice Address - Phone:605-646-2256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty