Basic Information
| Provider Information | |||||||||
| NPI: | 1356460059 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILEA | ||||||||
| FirstName: | BRANDY | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PCC-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3413 STARWICK DR | ||||||||
| Address2: | |||||||||
| City: | CANFIELD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444068049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305031923 | ||||||||
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| Practice Location | |||||||||
| Address1: | 611 BELMONT AVE | ||||||||
| Address2: | |||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445021037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307442991 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 05/22/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E8072 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.