Healthcare Provider Details

I. General information

NPI: 1043129083
Provider Name (Legal Business Name): IRINA BRANSTETER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 WOOSTER RD APT D36
ROCKY RIVER OH
44116-2648
US

IV. Provider business mailing address

2039 WOOSTER RD APT D36
ROCKY RIVER OH
44116-2648
US

V. Phone/Fax

Practice location:
  • Phone: 216-488-5487
  • Fax:
Mailing address:
  • Phone: 216-488-5487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: IRINA BRANSTETER
Title or Position: OWNER
Credential: PHD
Phone: 216-488-5487