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General NPI Number Information
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NPI Number | 1548677032
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Entity Type | Organization
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Legal Business Name | AJ BRANDON COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 10400 VINEYARD BLVD SUITE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-3829
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Country | US
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Telephone | 405-204-6424
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Fax | 405-242-5345
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Provider Business Mailing Address
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Address Line | 10400 VINEYARD BLVD SUITE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-3829
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Country | US
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Telephone | 405-204-6424
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Fax | 405-242-5345
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Authorized Official
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Title or Position | LPC
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Name | MS. AMANDA J BRANDON
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Credential | MS
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Telephone | 405-204-6424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5385
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License Number State | OK
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