Provider Demographics
NPI:1831696020
Name:RAUCH, BRANDI LYNN (AAS, QMHS3)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:LYNN
Last Name:RAUCH
Suffix:
Gender:F
Credentials:AAS, QMHS3
Other - Prefix:MRS
Other - First Name:BRANDI
Other - Middle Name:L
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1423
Mailing Address - Country:US
Mailing Address - Phone:937-238-9554
Mailing Address - Fax:
Practice Address - Street 1:3095 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1983
Practice Address - Country:US
Practice Address - Phone:937-293-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator