Provider Demographics
NPI:1780337428
Name:BRAMBLETT, BRANDIE (CSW)
Entity type:Individual
Prefix:
First Name:BRANDIE
Middle Name:
Last Name:BRAMBLETT
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:BRANDIE
Other - Middle Name:
Other - Last Name:AVANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:914 N CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5110
Mailing Address - Country:US
Mailing Address - Phone:575-885-4836
Mailing Address - Fax:505-443-8319
Practice Address - Street 1:914 N CANAL ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5110
Practice Address - Country:US
Practice Address - Phone:575-885-4836
Practice Address - Fax:505-443-8319
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist