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General NPI Number Information
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NPI Number | 1629608500
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Entity Type | Individual
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Provider Name | BRANDI JO MAURIELLO MA
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Gender | Female
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Dates
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Enumeration Date | 01/20/2020
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 139 W MARKET ST STE D
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City | WEST CHESTER
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State | PA
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Zip | 19382-2912
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Country | US
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Telephone | 717-360-6267
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Fax | 888-976-5828
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Provider Business Mailing Address
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Address Line | 102 HAWTHORNE CT
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City | COLLEGEVILLE
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State | PA
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Zip | 19426-3918
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Country | US
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Telephone | 717-360-6267
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Fax | 888-976-5828
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC012104
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License Number State | PA
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