Provider Demographics
NPI:1649543356
Name:BRANDON, SABRENAY S (MA)
Entity type:Individual
Prefix:
First Name:SABRENAY
Middle Name:S
Last Name:BRANDON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-1720
Mailing Address - Country:US
Mailing Address - Phone:609-816-1956
Mailing Address - Fax:973-266-7970
Practice Address - Street 1:1405 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-1720
Practice Address - Country:US
Practice Address - Phone:609-816-1956
Practice Address - Fax:973-266-7970
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health