Individual
STACEY BRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMM
Contact information
Practice address
15318 N MAY AVE STE A, EDMOND, OK 73013-8864
(405) 204-8997
Mailing address
4401 LOMBARDY LN, OKLAHOMA CITY, OK 73112-2534
(405) 204-8997
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1994
OK
Other
Enumeration date
07/15/2024
Last updated
09/19/2025
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