Provider Demographics
NPI:1245488162
Name:MARCUM, BRANDI L (AUD, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:L
Last Name:MARCUM
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:MISS
Other - First Name:BRANDI
Other - Middle Name:L
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:1609 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-6420
Mailing Address - Country:US
Mailing Address - Phone:931-381-0831
Mailing Address - Fax:931-380-0750
Practice Address - Street 1:1609 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6420
Practice Address - Country:US
Practice Address - Phone:931-381-0831
Practice Address - Fax:931-380-0750
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA1511231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist