Doctor Name: | BRANDI THORNBRUGH |
NPI Number: | 1679607840 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | CG60156026 |
Business Practice Address: | 1031 Burgundy Pl Prosser, WA - 993501223 |
Business Phone Number: | 5097864196 |
Business Fax Number: | |
Mailing Address: | 1031 Burgundy Pl, PROSSER |
State: | WA |
Postal Code: | 993501223 |
Phone Number: | 5097864196 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 12/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CG60156026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |