Provider Demographics
NPI:1003073339
Name:JOKIEL, BRANDELYN RACHELLE (CCHT)
Entity Type:Individual
Prefix:MRS
First Name:BRANDELYN
Middle Name:RACHELLE
Last Name:JOKIEL
Suffix:
Gender:F
Credentials:CCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 EUBANK BLVD NE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-5386
Mailing Address - Country:US
Mailing Address - Phone:505-239-5784
Mailing Address - Fax:
Practice Address - Street 1:1201 EUBANK BLVD NE
Practice Address - Street 2:SUITE #2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5386
Practice Address - Country:US
Practice Address - Phone:505-239-5784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA.C.H.E. CHT#107-106174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist