Blackwell, Brandy Lynn
Blackwell, Brandy Lynn is an individual health care provider with primary practice located at 91150 N Coburg Industrial Way , Coburg OR 97408-1313. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Blackwell, Brandy Lynn can be contacted via phone (541) 284-5673.Contact Information
Primary practice address
91150 N Coburg Industrial Way
Coburg OR 97408-1313
Phone: (541) 284-5673
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 19-P-15 | Oregon |
Profile Details
| NPI number | 1639716525 |
|---|---|
| LBN Legal business name | Blackwell, Brandy Lynn |
| Credentials | CADC 1 |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 10th, 2019 |
| Last updated | Dec 10th, 2019 - about 7 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 | 1639716525 | NPPES |
| Oregon | Other | 1104934892 | NPI |
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