Provider Demographics
NPI:1184067472
Name:HAMMON, BRANDIY SHARAAHN
Entity type:Individual
Prefix:MS
First Name:BRANDIY
Middle Name:SHARAAHN
Last Name:HAMMON
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 1:507 S OKMULGEE AVE
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-4927
Mailing Address - Country:US
Mailing Address - Phone:918-799-9028
Mailing Address - Fax:
Practice Address - Street 1:201 E 5TH ST
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-4000
Practice Address - Country:US
Practice Address - Phone:918-756-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health