Provider Demographics
NPI:1497792766
Name:STEELE, BRANDI (OTD,OTR/L)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:STEELE
Suffix:
Gender:F
Credentials:OTD,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 HIGH RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8426
Mailing Address - Country:US
Mailing Address - Phone:870-926-7725
Mailing Address - Fax:870-933-9293
Practice Address - Street 1:3114 FOX RD
Practice Address - Street 2:SUITE A
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9322
Practice Address - Country:US
Practice Address - Phone:870-926-7725
Practice Address - Fax:870-933-9293
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR1783174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR148504721Medicaid
AR5X748OtherBLUECROSS PROVIDER #