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General NPI Number Information
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NPI Number | 1851781264
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Entity Type | Individual
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Provider Name | MARGUERITE BRADEN MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2015
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1214 ELLIS AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3326
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Country | US
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Telephone | 936-637-0074
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Fax | 936-637-0081
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Provider Business Mailing Address
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Address Line | 1214 ELLIS AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3326
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Country | US
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Telephone | 936-637-0074
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Fax | 936-637-0081
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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 | 69212
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License Number State | TX
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