Provider Demographics
NPI:1558687186
Name:GLASS HAMMILL, BRANDY (MS)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:GLASS HAMMILL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:MARIE
Other - Last Name:GLASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16607 BLANCO RD STE 502
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1910
Mailing Address - Country:US
Mailing Address - Phone:210-416-1621
Mailing Address - Fax:
Practice Address - Street 1:16607 BLANCO RD STE 502
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1910
Practice Address - Country:US
Practice Address - Phone:210-416-1621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201299106H00000X
TX64781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist