Provider Demographics
NPI:1215519020
Name:FLAMEZ MCDEVITT, BRANDE NICOLE
Entity type:Individual
Prefix:
First Name:BRANDE
Middle Name:NICOLE
Last Name:FLAMEZ MCDEVITT
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 1:15857 EL SOCCORRO LOOP
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-6603
Mailing Address - Country:US
Mailing Address - Phone:574-904-8186
Mailing Address - Fax:
Practice Address - Street 1:15857 EL SOCCORRO LOOP
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-6603
Practice Address - Country:US
Practice Address - Phone:574-904-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68826101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional