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General NPI Number Information
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NPI Number | 1881984284
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Entity Type | Individual
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Provider Name | BRANDI NICOLE CANNON MA:MFT US
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Gender | Female
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 2448 E 81ST ST
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City | TULSA
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State | OK
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Zip | 74137-4250
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Country | US
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Telephone | 918-606-7242
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Fax |
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Provider Business Mailing Address
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Address Line | 8643 E 77TH PL
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City | TULSA
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State | OK
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Zip | 74133-3710
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Country | US
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Telephone | 918-606-7242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1137
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License Number State | OK
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