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General NPI Number Information
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NPI Number | 1700029725
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Entity Type | Individual
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Provider Name | KRISTIN SNYDER BRANDON LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 07/17/2019
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Provider Practice Location Address
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Address Line | 920 PAVERSTONE DR STE D
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City | RALEIGH
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State | NC
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Zip | 27615-4723
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Country | US
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Telephone | 919-896-2256
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Fax |
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Provider Business Mailing Address
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Address Line | 17 KAKI CT
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City | SELMA
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State | NC
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Zip | 27576-5752
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Country | US
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Telephone | 574-304-2516
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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 | 33004939A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C010831
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License Number State | NC
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