Doctor Name: | MRS. BRANDY LYNN CHILDRESS |
NPI Number: | 1336424233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS PPC |
License Number: | PPC-941 |
Business Practice Address: | 2000 Westland Rd Suite C Cheyenne, WY - 820013309 |
Business Phone Number: | 3076319551 |
Business Fax Number: | |
Mailing Address: | 304 R St, ROCK SPRINGS |
State: | WY |
Postal Code: | 829016526 |
Phone Number: | 3073714688 |
Fax Number: | |
NPI Enumeration Date: | 10/12/2011 |
NPI Last Update Date: | 03/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | PPC-941 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |