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1902378003
BRANDIE LYNNE IMPERIAL
PORTLAND, OR
NPI
1902378003
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Former Name
BRANDIE LYNNE FAZAL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L6754)
Enumeration Date
2018-12-30
Last Update Date
2018-12-30
Business Address
BRANDIE LYNNE IMPERIAL LCSW, CADCI
10175 SW BARBUR BLVD STE 204B
PORTLAND, OR 97219-5953
Phone number: 971-666-1290
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Mailing Address
BRANDIE LYNNE IMPERIAL LCSW, CADCI
10175 SW BARBUR BLVD STE 204B
PORTLAND, OR 97219-5953
Phone number: 971-666-1290
Copy
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