Provider Demographics
NPI:1558162826
Name:BRAINBRIDGE PSYCHOLOGICAL AND BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:BRAINBRIDGE PSYCHOLOGICAL AND BEHAVIORAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIERZCHOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-600-2647
Mailing Address - Street 1:8150 N CENTRAL EXPY STE 1450
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1992
Mailing Address - Country:US
Mailing Address - Phone:214-600-2647
Mailing Address - Fax:214-265-1425
Practice Address - Street 1:8150 N CENTRAL EXPY STE 1450
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-1992
Practice Address - Country:US
Practice Address - Phone:214-600-2647
Practice Address - Fax:214-265-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-22
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty