| Doctor Name: | JEANETTE D BRANDT |
| NPI Number: | 1407940588 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 1266 |
| Business Practice Address: | 214 E Main St Tucumcari, NM - 884012223 |
| Business Phone Number: | 5054616080 |
| Business Fax Number: | 5054614802 |
| Mailing Address: | 214 W Barnes Ave, TUCUMCARI |
| State: | NM |
| Postal Code: | 884013271 |
| Phone Number: | 5054616080 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |