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General NPI Number Information
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NPI Number | 1396864757
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Entity Type | Individual
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Provider Name | ANDREA L BRANDON MENEFEE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 270 E 90TH DR
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City | MERRILLVILLE
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State | IN
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Zip | 46410-8102
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Country | US
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Telephone | 219-779-7339
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Fax | 219-979-5149
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Provider Business Mailing Address
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Address Line | 270 EAST 90TH DRIVE OFFICE NUMBER 223
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City | MERRILLVILLE
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State | IN
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Zip | 46410-8102
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Country | US
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Telephone | 219-779-7339
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Fax | 219-226-1324
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20042619A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 20042619A
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License Number State | IN
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