Provider Demographics
NPI:1396993242
Name:SCOTT, BRANDI LEE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 ETIWANDA AVE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-9662
Mailing Address - Country:US
Mailing Address - Phone:909-463-5101
Mailing Address - Fax:909-463-5233
Practice Address - Street 1:9500 ETIWANDA AVE.
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739
Practice Address - Country:US
Practice Address - Phone:909-463-5101
Practice Address - Fax:909-463-5233
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44167106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist