Provider Demographics
NPI:1386311561
Name:SWEET, BRINNLEE A (BS,CMLL)
Entity type:Individual
Prefix:
First Name:BRINNLEE
Middle Name:A
Last Name:SWEET
Suffix:
Gender:F
Credentials:BS,CMLL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19556 STATE HIGHWAY 83
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:OK
Mailing Address - Zip Code:74940-3062
Mailing Address - Country:US
Mailing Address - Phone:918-839-1497
Mailing Address - Fax:
Practice Address - Street 1:210 S WILSON ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-4917
Practice Address - Country:US
Practice Address - Phone:918-649-0011
Practice Address - Fax:918-649-0066
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management