Provider Demographics
NPI:1972899722
Name:BRANDT, KAREN SUE (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:BRANDT
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 4TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2448
Mailing Address - Country:US
Mailing Address - Phone:931-526-8863
Mailing Address - Fax:931-525-3559
Practice Address - Street 1:100 W 4TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2448
Practice Address - Country:US
Practice Address - Phone:931-526-8863
Practice Address - Fax:931-525-3559
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1563237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter