| Martha Ann Brandt, Inc | |
|
4770 Covert Ave Suite 230 Evansville IN 47714-5617 | |
| (812) 449-4006 | |
| (812) 475-3470 |
| Full Name | Martha Ann Brandt, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 4770 Covert Ave, Evansville, Indiana |
| Authorized Official Name and Position | Martha Ann Brandt (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8124494006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martha Ann Brandt, Inc 4770 Covert Ave Suite 230 Evansville IN 47714-5617 Ph: (812) 449-4006 | Martha Ann Brandt, Inc 4770 Covert Ave Suite 230 Evansville IN 47714-5617 Ph: (812) 449-4006 |
| NPI Number | 1467752071 |
|---|---|
| Provider Enumeration Date | 10/28/2010 |
| Last Update Date | 10/28/2010 |
| Medicare PECOS PAC ID | 1456545532 |
|---|---|
| Medicare Enrollment ID | O20101102001405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467752071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | IN34002417A (Indiana) | Primary |
| Provider Name | Martha A Brandt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114900412 PECOS PAC ID: 4981898061 Enrollment ID: I20101102001455 |
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