| Doctor Name: | JOHN M BRANDON |
| NPI Number: | 1164469359 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | 404 LCPC |
| Business Practice Address: | 7325 Us Highway 93 Suite 4 Lakeside, MT - 599229704 |
| Business Phone Number: | 4068442890 |
| Business Fax Number: | 4068442891 |
| Mailing Address: | 202 Conway Dr, Suite 100 KALISPELL |
| State: | MT |
| Postal Code: | 599013112 |
| Phone Number: | 4067515664 |
| Fax Number: | 4067550971 |
| NPI Enumeration Date: | 05/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 404 LCPC |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |