Provider Demographics
NPI:1902510423
Name:WEITZEL, BRANDALYNE BINEHAM (LPC)
Entity Type:Individual
Prefix:
First Name:BRANDALYNE
Middle Name:BINEHAM
Last Name:WEITZEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:
Other - Last Name:BINEHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:9759 ADDERSLY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-6140
Mailing Address - Country:US
Mailing Address - Phone:210-268-5842
Mailing Address - Fax:
Practice Address - Street 1:9759 ADDERSLY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-6140
Practice Address - Country:US
Practice Address - Phone:210-268-5842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health