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NPI Code Detail

MEDICARE: BRANDY GAYHEART

MEDICARE: BRANDY GAYHEART
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
1106S00000XBehavior Technician
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1700613320
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDY GAYHEART
Provider Business Mailing Address
First Line : 100 CROWNE POINT PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45241-5427
Country : US
Telephone Number : 513-743-7628
Fax Number :
Provider Business Practice Location Address
First Line : 100 CROWNE POINT PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45241-5427
Country : US
Telephone Number : 513-743-7628
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2024
Last Update Date : 09/17/2024

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