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General NPI Number Information
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NPI Number | 1659385466
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Entity Type | Individual
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Provider Name | BRANDI L PAGE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3495 BAILEY AVE
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City | BUFFALO
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State | NY
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Zip | 14215-1129
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Country | US
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Telephone | 716-862-3105
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Fax |
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Provider Business Mailing Address
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Address Line | 47 WILLOW GREEN DR
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City | AMHERST
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State | NY
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Zip | 14228-3421
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Country | US
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Telephone | 716-691-4463
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 074734
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License Number State | NY
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