Provider Demographics
NPI:1255740080
Name:DELHOMME, BRANDY KRISTIN (BA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:KRISTIN
Last Name:DELHOMME
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-4806
Mailing Address - Country:US
Mailing Address - Phone:918-696-5536
Mailing Address - Fax:918-696-5397
Practice Address - Street 1:716 S 2ND ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-4806
Practice Address - Country:US
Practice Address - Phone:918-696-5536
Practice Address - Fax:918-696-5397
Is Sole Proprietor?:No
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health