Most Relevant Information
Provider Data
| NPI Number: | 1003323262 |
| Provider Name: | KIMBERLY BRANDL |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | PO3869 |
Most Important Dates
| Enumeration Date: | 01/09/2018 |
| Last Updated: | 01/17/2024 |
Provider Practice Location
5701 E CIRCLE DR # 163
CICERO
NY
130398638
Practice Location Phone/Fax
| Phone: | 3152040610 |
| Fax: | 3152604332 |
Provider Mailing Location
141 COUNTY ROUTE 23A
CONSTANTIA
NY
130443737
Provider Mailing Phone/Fax
| Phone: | 3152040610 |
| Fax: | 3152604332 |