Provider Demographics
NPI:1780820340
Name:BAILEY, BRANDI MICHELLE (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:MICHELLE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 W ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-1586
Mailing Address - Country:US
Mailing Address - Phone:405-590-8710
Mailing Address - Fax:
Practice Address - Street 1:2109 W ASHLEY DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025-1586
Practice Address - Country:US
Practice Address - Phone:405-590-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2972235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist