Provider Demographics
NPI:1245512367
Name:HAMILTON, BRANDI LYNN (BSW)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:LYNN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11297 N 1976 RD
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-6002
Mailing Address - Country:US
Mailing Address - Phone:580-225-4133
Mailing Address - Fax:
Practice Address - Street 1:11297 N 1976 RD
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-6002
Practice Address - Country:US
Practice Address - Phone:580-225-4133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst