Most Relevant Information
Provider Data
| NPI Number: | 1003305327 |
| Provider Name: | BRANDIE LEGION |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/02/2018 |
| Last Updated: | 05/02/2018 |
Provider Practice Location
2809 CLUBHOUSE DR
WEST DEPTFORD
NJ
080662117
Practice Location Phone/Fax
| Phone: | 2673399017 |
| Fax: |
Provider Mailing Location
2809 CLUBHOUSE DR
WEST DEPTFORD
NJ
080662117
Provider Mailing Phone/Fax
| Phone: | 2673399017 |
| Fax: |