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NPI Code Detail

MEDICARE: CAROLINE ANNE BRAVO LPC, MA

MEDICARE: CAROLINE ANNE BRAVO LPC, MA
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
1101Y00000XCounselor4324TN

General Provider Information

NPI Number : 1992391866
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE ANNE BRAVO LPC, MA
Provider Business Mailing Address
First Line : 1305 16TH AVE S
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-2923
Country : US
Telephone Number : 615-434-5779
Fax Number :
Provider Business Practice Location Address
First Line : 1305 16TH AVE S
Second Line :
City : NASHVILLE
State : TN
Zip : 37212-2923
Country : US
Telephone Number : 615-434-5779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2020
Last Update Date : 12/15/2020

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