Provider Demographics
NPI:1982735304
Name:BRANDON, JANET SLATER (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:SLATER
Last Name:BRANDON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620
Mailing Address - Country:US
Mailing Address - Phone:410-778-5550
Mailing Address - Fax:
Practice Address - Street 1:818 HIGH ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620
Practice Address - Country:US
Practice Address - Phone:410-778-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01371103T00000X
MD1371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD13631OtherJOHNS HOPKINS
MD5659021700Medicaid
MDT4180003OtherBCBS GHMSI
MD285935OtherMAMSI
MD411270-04OtherBLUE CROSS BLUE SHIELD MD
MDPVPB1199OtherAPS PROVIDER NO
MD61-71014OtherUBH PROVIDER NO
MD001326OtherVALUE OPTIONS
MD13631OtherJOHNS HOPKINS