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General NPI Number Information
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NPI Number | 1154135085
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Entity Type | Individual
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Provider Name | BRANDI S RARIDEN EP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 23507 HOLLYWOOD RD STE 2
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City | LEONARDTOWN
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State | MD
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Zip | 20650-5928
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Country | US
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Telephone | 240-434-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 43968 SWIFT FOX DR
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City | CALIFORNIA
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State | MD
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Zip | 20619-7124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number | 776820
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License Number State | FL
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