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General NPI Number Information
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NPI Number | 1932819281
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Entity Type | Individual
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Provider Name | KENISHA FLORENCE BRASWELL LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/28/2022
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Last Update Date | 05/14/2023
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Provider Practice Location Address
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Address Line | 111 JEWEL DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2715
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Country | US
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Telephone | 863-330-0535
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Fax | 863-877-4682
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Provider Business Mailing Address
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Address Line | 113 SILVER MAPLE BND
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City | DAVENPORT
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State | FL
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Zip | 33837-9533
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Country | US
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Telephone | 407-990-2743
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20748
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License Number State | FL
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