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NPI Code Detail

MEDICARE: RYAN ALLEN BRABRAND LCAS-A

MEDICARE:   RYAN ALLEN BRABRAND  LCAS-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-23891NC

General Provider Information

NPI Number : 1457865065
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN ALLEN BRABRAND LCAS-A
Provider Business Mailing Address
First Line : 321 S 5TH AVE APT B
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-4518
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1221 FLORAL PKWY STE 207
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-6235
Country : US
Telephone Number : 910-465-8972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2017
Last Update Date : 11/20/2017

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Directions to “ RYAN ALLEN BRABRAND LCAS-A” Practice Location

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