Healthcare Provider Details

I. General information

NPI: 1730097106
Provider Name (Legal Business Name): BRANDY S. PEOPLES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 COACHWAY LN
HAZELWOOD MO
63042-1347
US

IV. Provider business mailing address

671 COACHWAY LN
HAZELWOOD MO
63042-1347
US

V. Phone/Fax

Practice location:
  • Phone: 314-400-8459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2014040940
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2014040940
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: