Provider Demographics
NPI:1235485228
Name:VANN, BRANIGHAN H
Entity Type:Individual
Prefix:
First Name:BRANIGHAN
Middle Name:H
Last Name:VANN
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 1:11109 N BRAUER AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7105
Mailing Address - Country:US
Mailing Address - Phone:405-326-0200
Mailing Address - Fax:
Practice Address - Street 1:11109 N BRAUER AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-7105
Practice Address - Country:US
Practice Address - Phone:405-326-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional