Provider Demographics
NPI:1427526011
Name:SMITH, BRANDY (QMHS)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 WILLIAMSTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26187-8168
Mailing Address - Country:US
Mailing Address - Phone:304-834-4619
Mailing Address - Fax:
Practice Address - Street 1:1307 WILLIAMSTOWN PIKE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:WV
Practice Address - Zip Code:26187-8168
Practice Address - Country:US
Practice Address - Phone:304-834-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator