Provider Demographics
NPI:1922270032
Name:HARPER, BRANDI GRIFFIN (FAAA,CCC-A, MS)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:GRIFFIN
Last Name:HARPER
Suffix:
Gender:F
Credentials:FAAA,CCC-A, MS
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:MICHELLE
Other - Last Name:CARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FAAA,CCC-A, MS
Mailing Address - Street 1:415 S 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7246
Mailing Address - Country:US
Mailing Address - Phone:601-579-3310
Mailing Address - Fax:601-579-5240
Practice Address - Street 1:1605 S 28TH AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-3110
Practice Address - Country:US
Practice Address - Phone:601-579-3310
Practice Address - Fax:601-264-0231
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA2065231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS512I640025Medicare PIN