Provider Demographics
NPI:1962751933
Name:MASTERSON, BRANDEE LYNN
Entity type:Individual
Prefix:
First Name:BRANDEE
Middle Name:LYNN
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2068 EVELYN AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5416
Mailing Address - Country:US
Mailing Address - Phone:731-234-1873
Mailing Address - Fax:
Practice Address - Street 1:6858 SWINNEA RD BLDG 6B
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-9493
Practice Address - Country:US
Practice Address - Phone:662-426-6136
Practice Address - Fax:662-499-6136
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst