| Doctor Name: | MS. J. PHYLLIS BRANNEN |
| NPI Number: | 1003993874 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, CAP |
| License Number: | CAP 2553 |
| Business Practice Address: | 1503 Pine St Melbourne, FL - 329013120 |
| Business Phone Number: | 3219533225 |
| Business Fax Number: | 3219533252 |
| Mailing Address: | 146 San Juan Cir, MELBOURNE |
| State: | FL |
| Postal Code: | 329355419 |
| Phone Number: | 3212555426 |
| Fax Number: | 3219533252 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 11/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CAP 2553 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |