Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003172032 |
---|---|
Provider Name | Mrs. Brandy Nicholle Sargent |
First Address | Midwest City, OK 73110-4121 |
Second Address | Oklahoma City, OK 73107-5700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2012 |
Last Update Date | 04/04/2012 |