Provider Demographics
NPI:1073952305
Name:GREENHOWARD, BRANDI TERESA
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:TERESA
Last Name:GREENHOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 N MERIDIAN AVE
Mailing Address - Street 2:APT 129
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-1006
Mailing Address - Country:US
Mailing Address - Phone:405-570-6885
Mailing Address - Fax:
Practice Address - Street 1:2634 N MERIDIAN AVE
Practice Address - Street 2:APT 129
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-1006
Practice Address - Country:US
Practice Address - Phone:405-570-6885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional