Provider Demographics
NPI:1134449861
Name:ANDREWS, BRYANT JR
Entity type:Individual
Prefix:
First Name:BRYANT
Middle Name:
Last Name:ANDREWS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 SE 58TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-4416
Mailing Address - Country:US
Mailing Address - Phone:405-308-9379
Mailing Address - Fax:
Practice Address - Street 1:4801 N CLASSEN BLVD STE 233
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4625
Practice Address - Country:US
Practice Address - Phone:405-242-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor