Provider Demographics
NPI:1740228113
Name:VOWELL, BRANDY DIANE (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:DIANE
Last Name:VOWELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:521 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-4136
Mailing Address - Country:US
Mailing Address - Phone:918-779-7500
Mailing Address - Fax:918-995-2333
Practice Address - Street 1:6050 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7412
Practice Address - Country:US
Practice Address - Phone:918-779-7500
Practice Address - Fax:918-779-7501
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK298231H00000X, 231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner