Healthcare Provider Details

I. General information

NPI: 1518258326
Provider Name (Legal Business Name): DONNA L BRACHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 TURNER ST SUITE A
LANSING MI
48906-4373
US

IV. Provider business mailing address

1310 TURNER ST SUITE A
LANSING MI
48906-4373
US

V. Phone/Fax

Practice location:
  • Phone: 517-974-2393
  • Fax:
Mailing address:
  • Phone: 517-974-2393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011208
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: