Individual
MRS. BRANDY LYNN CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
405 3RD AVE NE, KENMARE, ND 58746-7425
(701) 818-4967
(833) 502-4632
Mailing address
PO BOX 1384, MINOT, ND 58702-1384
(701) 818-4967
(833) 502-4632
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PPC-941
WY
101YM0800X
Mental Health Counselor
Primary
986-1-1-19-423
ND
101YP2500X
Professional Counselor
986-1-1-19
ND
101YP2500X
Professional Counselor
986-1-1-19-423
ND
101YP2500X
Professional Counselor
986-1-1-19-A
ND
Other
Enumeration date
10/12/2011
Last updated
02/10/2025
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