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General NPI Number Information
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NPI Number | 1922367366
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Entity Type | Organization
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Legal Business Name | D ROSS BRAUNE MA LPC AND ASSOCIATES
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 401 BROADWAY AVE. 100
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City | CUERO
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State | TX
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Zip | 77954
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Country | US
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Telephone | 361-652-8470
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Fax | 361-572-8578
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Provider Business Mailing Address
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Address Line | 111 WOODHAVEN DR
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City | VICTORIA
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State | TX
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Zip | 77904-1147
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Country | US
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Telephone | 361-652-8470
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Fax | 361-572-8578
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MR. DAVID ROSS BRAUNE SR.
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Credential | L.P.C.
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Telephone | 361-652-8470
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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 | 16804
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License Number State | TX
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