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General NPI Number Information
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NPI Number | 1871305870
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Entity Type | Organization
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Legal Business Name | BRAVER THERAPY AND LIFE DEVELOPMENT LLC
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Dates
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Enumeration Date | 01/25/2025
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Last Update Date | 01/25/2025
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Provider Practice Location Address
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Address Line | 1169 HILLTOP PKWY UNIT 104H
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-3173
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Country | US
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Telephone | 970-235-0404
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Fax |
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Provider Business Mailing Address
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Address Line | 7 JACKPINE CT
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City | STEAMBOAT SPRINGS
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State | CO
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Zip | 80487-1717
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Country | US
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Telephone | 970-331-3959
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | COULTER SOMES
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Credential | MFTC
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Telephone | 970-235-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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