Healthcare Provider Details

I. General information

NPI: 1891138673
Provider Name (Legal Business Name): BRALEY & THOMPSON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2013
Last Update Date: 04/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 TEJO LN SUITE 105
CHESAPEAKE VA
23321-5258
US

IV. Provider business mailing address

9901 LINN STATION RD
LOUISVILLE KY
40223-3808
US

V. Phone/Fax

Practice location:
  • Phone: 757-638-5500
  • Fax:
Mailing address:
  • Phone: 502-394-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DEENA G. OMBRES
Title or Position: ASSOC. GEN. COUNSEL/PRIVACY OFFICER
Credential:
Phone: 502-394-2100