Provider Demographics
NPI:1992097190
Name:SPIERS, BRENDA
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:SPIERS
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 1:6272 DOGWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6608
Mailing Address - Country:US
Mailing Address - Phone:678-691-1276
Mailing Address - Fax:
Practice Address - Street 1:6272 DOGWOOD TRL
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-6608
Practice Address - Country:US
Practice Address - Phone:678-691-1276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator