Provider Demographics
NPI:1598374399
Name:JUSTICE, BRANDI L (QMHS)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:L
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 SYMMES RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-1844
Mailing Address - Country:US
Mailing Address - Phone:513-645-4578
Mailing Address - Fax:513-883-1546
Practice Address - Street 1:2052 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-4746
Practice Address - Country:US
Practice Address - Phone:513-863-6383
Practice Address - Fax:513-863-9882
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker