Provider Demographics
NPI:1447688957
Name:SZABO, BRANDI
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:SZABO
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 1:113 MEMORIAL ST
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:PA
Mailing Address - Zip Code:15431-1621
Mailing Address - Country:US
Mailing Address - Phone:724-317-2139
Mailing Address - Fax:
Practice Address - Street 1:1070 OLD NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:PA
Practice Address - Zip Code:15333-2114
Practice Address - Country:US
Practice Address - Phone:724-317-2139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-18
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0181121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA129155OtherSTATE BOARD OF SOCIAL WORKERS, MARRIAGE AND FAMILY THERAPISTS AND PC'S.