Provider Demographics
NPI:1477189462
Name:WHITE, BRANDI LEIGH
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:LEIGH
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:LEIGH
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72512 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43983-9507
Mailing Address - Country:US
Mailing Address - Phone:740-238-0974
Mailing Address - Fax:
Practice Address - Street 1:67670 TRACO DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-9375
Practice Address - Country:US
Practice Address - Phone:740-695-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-21
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator