Provider Demographics
NPI:1336525245
Name:BRANDEN, TOBY
Entity type:Individual
Prefix:MS
First Name:TOBY
Middle Name:
Last Name:BRANDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHALONE
Other - Middle Name:
Other - Last Name:BRANDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1640 ANDRY ST
Mailing Address - Street 2:APT. B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70117-3202
Mailing Address - Country:US
Mailing Address - Phone:504-520-0125
Mailing Address - Fax:
Practice Address - Street 1:1640 ANDRY ST
Practice Address - Street 2:APT. B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70117-3202
Practice Address - Country:US
Practice Address - Phone:504-520-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10841104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker