Basic Information
| Provider Information | |||||||||
| NPI: | 1881159317 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NADEAU DEVEAU | ||||||||
| FirstName: | BRENDA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | RN, MHRT-C, LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 ACADEMY ST STE 3 | ||||||||
| Address2: | |||||||||
| City: | PRESQUE ISLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047693183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075542352 | ||||||||
| FaxNumber: | 2075542351 | ||||||||
| Practice Location | |||||||||
| Address1: | 127 PALMER ST | ||||||||
| Address2: | |||||||||
| City: | CALAIS | ||||||||
| State: | ME | ||||||||
| PostalCode: | 046191300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074540270 | ||||||||
| FaxNumber: | 2074540232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2019 | ||||||||
| LastUpdateDate: | 02/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN39939 | ME | N | Nursing Service Providers | Registered Nurse | 101Y00000X | LS1793 | ME | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.