Provider Demographics
NPI:1871719989
Name:BRANDES, BARBARA JO (PHD, LCSW, LSOTP)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:JO
Last Name:BRANDES
Suffix:
Gender:F
Credentials:PHD, LCSW, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1205
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-1205
Mailing Address - Country:US
Mailing Address - Phone:979-885-3489
Mailing Address - Fax:
Practice Address - Street 1:3701 OUTLET CENTER DR
Practice Address - Street 2:SUITE 90
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-4904
Practice Address - Country:US
Practice Address - Phone:979-885-8578
Practice Address - Fax:979-885-3275
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40766104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker