Provider Demographics
NPI:1740795673
Name:YARBROUGH, BRANDY MICHELLE
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:MICHELLE
Last Name:YARBROUGH
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 1:704 CHICKEN FARM RD
Mailing Address - Street 2:
Mailing Address - City:BRINKLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72021-9107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PALESTINE SCHOOLS 7950 HWY 70 W
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:AR
Practice Address - Zip Code:72372
Practice Address - Country:US
Practice Address - Phone:870-270-6948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP1550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist