Basic Information
| Provider Information | |||||||||
| NPI: | 1598366528 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRUMLEY | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | DANZI | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 OSAGE RD | ||||||||
| Address2: | |||||||||
| City: | CLAYMONT | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197031214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046616891 | ||||||||
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| Practice Location | |||||||||
| Address1: | 42 E LAUREL RD | ||||||||
| Address2: | |||||||||
| City: | STRATFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080841354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565667036 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2020 | ||||||||
| LastUpdateDate: | 11/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | B1-0011236 | DE | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.