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General NPI Number Information
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NPI Number | 1447897293
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Entity Type | Individual
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Provider Name | BRANDON TOMLINSON PHD
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Gender | Male
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 112 E ALLEN ST UNIT 3
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City | PHILADELPHIA
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State | PA
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Zip | 19125-4189
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Country | US
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Telephone | 269-832-5145
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Fax |
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Provider Business Mailing Address
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Address Line | 112 E ALLEN ST UNIT 3
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City | PHILADELPHIA
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State | PA
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Zip | 19125-4189
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Country | US
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Telephone | 269-832-5145
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2303373
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC016562
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License Number State | PA
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