Provider Demographics
NPI:1982138822
Name:FASHION BROKERAGE INTERNATIONAL
Entity Type:Organization
Organization Name:FASHION BROKERAGE INTERNATIONAL
Other - Org Name:GROWTH THRU CHANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDSTETTER
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, PSYD
Authorized Official - Phone:609-707-6496
Mailing Address - Street 1:1604 RODMAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1525
Mailing Address - Country:US
Mailing Address - Phone:609-707-6496
Mailing Address - Fax:
Practice Address - Street 1:203 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5524
Practice Address - Country:US
Practice Address - Phone:215-968-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1325831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty