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General NPI Number Information
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NPI Number | 1881115285
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Entity Type | Individual
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Provider Name | BENJAMIN GEORGE BRANEY
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Gender | Male
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 932 W STATE HIGHWAY 152
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City | MUSTANG
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State | OK
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Zip | 73064-2301
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Country | US
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Telephone | 405-577-5477
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Fax |
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Provider Business Mailing Address
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Address Line | 12734 N MACARTHUR BLVD APT E
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-2919
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Country | US
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Telephone | 909-223-4273
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 60738059
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License Number State | WA
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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 | R5432
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 60738059
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 11780
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License Number State | OK
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