Provider Demographics
NPI:1750646378
Name:BRUMMETT, KEIV (BHRS)
Entity Type:Individual
Prefix:
First Name:KEIV
Middle Name:
Last Name:BRUMMETT
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 S GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-8257
Mailing Address - Country:US
Mailing Address - Phone:580-889-2466
Mailing Address - Fax:
Practice Address - Street 1:675 S GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-8257
Practice Address - Country:US
Practice Address - Phone:580-889-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health