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NPI Code Detail

MEDICARE: MRS. BRANDI MICHEL SMITH

MEDICARE: MRS. BRANDI MICHEL SMITH
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
1171M00000XCase Manager/Care Coordinator
2101Y00000XCounselor

General Provider Information

NPI Number : 1053752980
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRANDI MICHEL SMITH
Provider Business Mailing Address
First Line : 5708 NW 113TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-3540
Country : US
Telephone Number : 405-413-8901
Fax Number :
Provider Business Practice Location Address
First Line : 2808 NW 31ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7407
Country : US
Telephone Number : 405-848-7555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2013
Last Update Date : 02/20/2017

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Directions to “ MRS. BRANDI MICHEL SMITH ” Practice Location

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