Provider Demographics
NPI:1386749729
Name:COX, BRENDA G II (HABILITATION SPECIAL)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:G
Last Name:COX
Suffix:II
Gender:F
Credentials:HABILITATION SPECIAL
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Mailing Address - Street 1:BRENDA COX
Mailing Address - Street 2:RT.1 BOX 216C
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070
Mailing Address - Country:US
Mailing Address - Phone:918-396-3782
Mailing Address - Fax:
Practice Address - Street 1:BRENDA COX
Practice Address - Street 2:RT.1 BOX 216C
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-9712
Practice Address - Country:US
Practice Address - Phone:918-396-3782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK003416332373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist