Provider Demographics
NPI:1841706108
Name:GUIDRY, BRANDI (LMT)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:GUIDRY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HEYMAN LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3574
Mailing Address - Country:US
Mailing Address - Phone:318-448-8462
Mailing Address - Fax:318-448-8486
Practice Address - Street 1:11 HEYMAN LN
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3574
Practice Address - Country:US
Practice Address - Phone:318-448-8462
Practice Address - Fax:318-448-8486
Is Sole Proprietor?:No
Enumeration Date:2017-12-22
Last Update Date:2017-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA5776225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist