Provider Demographics
NPI:1932376126
Name:LEBER, BRANDI NICOLE (BS, QMHP)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:NICOLE
Last Name:LEBER
Suffix:
Gender:F
Credentials:BS, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 WESLEY ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-4121
Mailing Address - Country:US
Mailing Address - Phone:903-348-3788
Mailing Address - Fax:
Practice Address - Street 1:2718 WESLEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-4121
Practice Address - Country:US
Practice Address - Phone:903-348-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health