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General NPI Number Information
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NPI Number | 1295476141
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Entity Type | Individual
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Provider Name | EMILY D BRAYTON LPC-A
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 2602 MCKINNEY AVE STE 105
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City | DALLAS
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State | TX
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Zip | 75204-0710
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Country | US
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Telephone | 214-444-3649
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Fax |
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Provider Business Mailing Address
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Address Line | 4444 COLE AVE APT 312
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City | DALLAS
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State | TX
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Zip | 75205-4368
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Country | US
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Telephone | 214-458-2580
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 88287
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License Number State | TX
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