Provider Demographics
NPI:1043361496
Name:BRAND, EULALEE (PHD)
Entity type:Individual
Prefix:DR
First Name:EULALEE
Middle Name:
Last Name:BRAND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:EULALEE
Other - Middle Name:
Other - Last Name:BRAND-CLINGEMPEEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 6603
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-6603
Mailing Address - Country:US
Mailing Address - Phone:843-662-6312
Mailing Address - Fax:843-662-6312
Practice Address - Street 1:607 W EVANS ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3409
Practice Address - Country:US
Practice Address - Phone:843-662-6312
Practice Address - Fax:843-662-6312
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC458103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical