Provider Demographics
NPI:1588702112
Name:HASSETT-CLARK, BRANDY (PT)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:HASSETT-CLARK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:HASSETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6060 WATSON CT
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6328
Mailing Address - Country:US
Mailing Address - Phone:443-694-0982
Mailing Address - Fax:
Practice Address - Street 1:194 THOMAS JOHNSON DR STE B
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4683
Practice Address - Country:US
Practice Address - Phone:301-418-6434
Practice Address - Fax:301-418-6433
Is Sole Proprietor?:No
Enumeration Date:2007-02-04
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist