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General NPI Number Information
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NPI Number | 1366242653
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Entity Type | Organization
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Legal Business Name | KATHERINE BRACKEN, PHD, PLLC
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Dates
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Enumeration Date | 03/15/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 8951 HARVEST OAKS DR STE 201
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City | RALEIGH
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State | NC
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Zip | 27615-2114
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Country | US
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Telephone | 984-266-2839
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Fax | 984-220-9477
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Provider Business Mailing Address
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Address Line | 8951 HARVEST OAKS DR STE 201
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City | RALEIGH
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State | NC
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Zip | 27615-2114
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Country | US
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Telephone | 984-266-2839
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Fax | 984-220-9477
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Authorized Official
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Title or Position | OWNER
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Name | DR. KATHERINE BRACKEN
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Credential | PHD
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Telephone | 919-667-6783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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