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General NPI Number Information
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NPI Number | 1649940966
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Entity Type | Individual
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Provider Name | MELISSA BRENDEL
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Gender | Female
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Dates
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Enumeration Date | 09/17/2021
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 37 MAIN ST
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City | REISTERSTOWN
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State | MD
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Zip | 21136-1236
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Country | US
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Telephone | 410-526-7882
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Fax |
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Provider Business Mailing Address
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Address Line | 1109 CHARLES VIEW WAY APT C
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City | TOWSON
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State | MD
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Zip | 21204-2118
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Country | US
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Telephone | 410-446-9955
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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 | LGP10879
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License Number State | MD
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