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NPI Code Detail

MEDICARE: BRANDY MARIE CLEMMER

MEDICARE: BRANDY MARIE CLEMMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417886490
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY MARIE CLEMMER
Provider Business Mailing Address
First Line : PO BOX 236
Second Line :
City : COTTON
State : MN
Zip : 55724-0236
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 910 8TH ST S
Second Line :
City : VIRGINIA
State : MN
Zip : 55792-3236
Country : US
Telephone Number : 218-748-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2026
Last Update Date : 05/15/2026

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Directions to “ BRANDY MARIE CLEMMER ” Practice Location

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