Healthcare Provider Details

I. General information

NPI: 1538209358
Provider Name (Legal Business Name): DAWN BRANDENBURGH L.P.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6202 S LEWIS AVE STE J
TULSA OK
74136-1064
US

IV. Provider business mailing address

6202 S LEWIS AVE STE J
TULSA OK
74136-1064
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-7988
  • Fax: 918-392-7989
Mailing address:
  • Phone: 918-392-7988
  • Fax: 918-392-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number05370
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: