Healthcare Provider Details

I. General information

NPI: 1871305870
Provider Name (Legal Business Name): BRAVER THERAPY AND LIFE DEVELOPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2025
Last Update Date: 01/25/2025
Certification Date: 01/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 HILLTOP PKWY UNIT 104H
STEAMBOAT SPRINGS CO
80487-3173
US

IV. Provider business mailing address

7 JACKPINE CT
STEAMBOAT SPRINGS CO
80487-1717
US

V. Phone/Fax

Practice location:
  • Phone: 970-235-0404
  • Fax:
Mailing address:
  • Phone: 970-331-3959
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: COULTER SOMES
Title or Position: OWNER
Credential: MFTC
Phone: 970-235-0404