Provider Demographics
NPI:1205571940
Name:HO, BRENDA CHRISTINE (RD)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:CHRISTINE
Last Name:HO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:CHRISTINE
Other - Last Name:HAMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:5375 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9666
Mailing Address - Country:US
Mailing Address - Phone:724-444-4700
Mailing Address - Fax:724-444-4730
Practice Address - Street 1:5375 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9666
Practice Address - Country:US
Practice Address - Phone:724-444-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA896017133V00000X
PADN001894133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered