Provider Demographics
NPI:1972677425
Name:BRANDEL, IRVIN. W (PHD)
Entity Type:Individual
Prefix:DR
First Name:IRVIN.
Middle Name:W
Last Name:BRANDEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 S CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1960
Mailing Address - Country:US
Mailing Address - Phone:330-666-5033
Mailing Address - Fax:
Practice Address - Street 1:1655 W MARKET ST
Practice Address - Street 2:SUITE J
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7004
Practice Address - Country:US
Practice Address - Phone:330-867-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2168103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist