Provider Demographics
NPI:1366111635
Name:SMITH, BRANDY L (PHD)
Entity type:Individual
Prefix:DR
First Name:BRANDY
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1767 SOLAMERE CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-5101
Mailing Address - Country:US
Mailing Address - Phone:901-218-8463
Mailing Address - Fax:
Practice Address - Street 1:1767 SOLAMERE CT
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5101
Practice Address - Country:US
Practice Address - Phone:901-218-8463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1745103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist