Brandmiller, Diane M
Brandmiller, Diane M is an sole proprietor health care provider with primary practice located at 2592 N. Gregg Avenue, Suite 34 , Fayetteville AR 72703. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Brandmiller, Diane M can be contacted via phone (479) 225-7799.Contact Information
Primary practice address
2592 N. Gregg Avenue, Suite 34
Fayetteville AR 72703
Phone: (479) 225-7799
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 05-14P | Arkansas |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2013010695 | Missouri |
Profile Details
| NPI number | 1447295043 |
|---|---|
| LBN Legal business name | Brandmiller, Diane M |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 18th, 2006 |
| Last updated | May 28th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447295043 | NPPES |
| Arkansas | Other | 162149719 | DOMHA MCD |
| Arkansas | Other | 5A091 | DOMHA MCD |
| Arkansas | Other | 5Y827 | DOMHA MCD |
| Arkansas | Other | P00363 | DOMHA MCD |
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