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General NPI Number Information
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NPI Number | 1558162826
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Entity Type | Organization
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Legal Business Name | BRAINBRIDGE PSYCHOLOGICAL AND BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 03/22/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 8150 N CENTRAL EXPY STE 1450
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City | DALLAS
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State | TX
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Zip | 75206-1992
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Country | US
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Telephone | 214-600-2647
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Fax | 214-265-1425
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Provider Business Mailing Address
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Address Line | 8150 N CENTRAL EXPY STE 1450
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City | DALLAS
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State | TX
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Zip | 75206-1992
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Country | US
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Telephone | 214-600-2647
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Fax | 214-265-1425
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Authorized Official
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Title or Position | NEUROPSYCHOLOGIST
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Name | DR. ANDREA WIERZCHOWSKI
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Credential | PHD
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Telephone | 214-600-2647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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