Provider Demographics
NPI:1982196879
Name:WRIGHT-DOHOPOLSKI, BRANDI (LAC)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:WRIGHT-DOHOPOLSKI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39081 DIANRON RD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3925
Mailing Address - Country:US
Mailing Address - Phone:661-609-5998
Mailing Address - Fax:
Practice Address - Street 1:27820 FREEMONT COURT , UNIT 5, SUITE E
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-609-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18096171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty