Healthcare Provider Details

I. General information

NPI: 1659998490
Provider Name (Legal Business Name): BRANDI HONORE-PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2020
Last Update Date: 06/27/2020
Certification Date: 06/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 CARDIFF WAY
BEAR DE
19701-8305
US

IV. Provider business mailing address

125 RICKEY BLVD
BEAR DE
19701-8604
US

V. Phone/Fax

Practice location:
  • Phone: 302-397-1955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: