Brandt, Jeanette D

Brandt, Jeanette D is an individual health care provider with primary practice located at 214 E Main St , Tucumcari NM 88401-2223. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Brandt, Jeanette D can be contacted via phone (505) 461-6080.

Contact Information

Primary practice address
214 E Main St Tucumcari NM 88401-2223
Phone: (505) 461-6080
Fax: (505) 461-4802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1266 New Mexico

Profile Details

NPI number 1407940588
LBN Legal business name Brandt, Jeanette D
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407940588 NPPES
New Mexico MEDICAID 89534077

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