Provider Demographics
NPI:1336267202
Name:FERGUSON, BRANDI LYNN (BA BHRS CM-A)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:LYNN
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:BA BHRS CM-A
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2000 E LINCOLN RD
Mailing Address - Street 2:P.O. BOX 1527
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-7353
Mailing Address - Country:US
Mailing Address - Phone:580-286-6639
Mailing Address - Fax:580-286-5206
Practice Address - Street 1:2000 E LINCOLN RD
Practice Address - Street 2:BOX 1527
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-7353
Practice Address - Country:US
Practice Address - Phone:580-286-6639
Practice Address - Fax:580-286-5206
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health