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NPI Code Detail

MEDICARE: MS. BRITTANY TYSHE' DEMERY

MEDICARE: MS. BRITTANY TYSHE' DEMERY
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
1101YP2500XProfessional CounselorH082731241OK

General Provider Information

NPI Number : 1629327325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRITTANY TYSHE' DEMERY
Provider Business Mailing Address
First Line : 1608 NE 26TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73111-3203
Country : US
Telephone Number : 405-887-3842
Fax Number :
Provider Business Practice Location Address
First Line : 1608 NE 26TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73111-3203
Country : US
Telephone Number : 405-887-3842
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2012
Last Update Date : 09/10/2012

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Directions to “ MS. BRITTANY TYSHE' DEMERY ” Practice Location

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