Healthcare Provider Details

I. General information

NPI: 1346700317
Provider Name (Legal Business Name): KODY BRINDLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ALABAMA AVE SE STE 238
WASHINGTON DC
20032-4540
US

IV. Provider business mailing address

1100 ALABAMA AVE SE STE 238
WASHINGTON DC
20032-4540
US

V. Phone/Fax

Practice location:
  • Phone: 202-299-5334
  • Fax:
Mailing address:
  • Phone: 202-299-5334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number324259
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: