Provider Demographics
NPI:1154407377
Name:TINDALL, BRIAN N (PHD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:N
Last Name:TINDALL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 TOWN PARK BLVD
Mailing Address - Street 2:C
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685
Mailing Address - Country:US
Mailing Address - Phone:330-896-0856
Mailing Address - Fax:330-896-0887
Practice Address - Street 1:1790 TOWN PARK BLVD
Practice Address - Street 2:C
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685
Practice Address - Country:US
Practice Address - Phone:330-896-0856
Practice Address - Fax:330-896-0887
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1831101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional