Provider Demographics
NPI:1215467337
Name:BRAND, ESTHER MACKENZIE
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:MACKENZIE
Last Name:BRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 NW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2218
Mailing Address - Country:US
Mailing Address - Phone:405-227-7207
Mailing Address - Fax:
Practice Address - Street 1:2817 NW 24TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2218
Practice Address - Country:US
Practice Address - Phone:405-227-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health