Provider Demographics
NPI:1972056307
Name:BRANDOW, BROOKE MARIE
Entity type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:MARIE
Last Name:BRANDOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 MONTAGUE RD APT 101
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1004
Mailing Address - Country:US
Mailing Address - Phone:845-264-2884
Mailing Address - Fax:
Practice Address - Street 1:310 MONTAGUE RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1004
Practice Address - Country:US
Practice Address - Phone:845-264-2884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor