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NPI Code Detail

MEDICARE: BRANDI NICOLE CANNON MA:MFT US

MEDICARE: BRANDI NICOLE CANNON MA:MFT US
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
1106H00000XMarriage & Family Therapist1137OK

General Provider Information

NPI Number : 1881984284
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDI NICOLE CANNON MA:MFT US
Provider Business Mailing Address
First Line : 8643 E 77TH PL
Second Line :
City : TULSA
State : OK
Zip : 74133-3710
Country : US
Telephone Number : 918-606-7242
Fax Number :
Provider Business Practice Location Address
First Line : 2448 E 81ST ST
Second Line :
City : TULSA
State : OK
Zip : 74137-4250
Country : US
Telephone Number : 918-606-7242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2011
Last Update Date : 02/17/2026

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Directions to “ BRANDI NICOLE CANNON MA:MFT US” Practice Location

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