MEDICARE: BRANDY BETH BRASKET

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
1	225700000X	Massage Therapist	209253	OK

General Provider Information

NPI Number	:	1063347052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDY BETH BRASKET

Provider Business Mailing Address
First Line	:	6500 N GRAND BLVD APT 168
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-3429
Country	:	US
Telephone Number	:	405-468-3688
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 NW 63RD ST STE 132
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1934
Country	:	US
Telephone Number	:	405-265-9423
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ BRANDY BETH BRASKET ” Practice Location

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