Provider Demographics
NPI:1548574163
Name:SANDLER, BROOK JENNIFER
Entity Type:Individual
Prefix:MRS
First Name:BROOK
Middle Name:JENNIFER
Last Name:SANDLER
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 1:2712 GLENCROFT RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-5318
Mailing Address - Country:US
Mailing Address - Phone:703-319-2034
Mailing Address - Fax:
Practice Address - Street 1:2712 GLENCROFT RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181-5318
Practice Address - Country:US
Practice Address - Phone:703-319-2034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW52741041C0700X
MI68010811921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical