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General NPI Number Information
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NPI Number | 1942859095
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Entity Type | Organization
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Legal Business Name | THE BRACKETTE FIRM LLC
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 2002 SUMMIT BLVD STE 300
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City | BROOKHAVEN
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State | GA
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Zip | 30319
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Country | US
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Telephone | 404-303-1864
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 420634
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City | ATLANTA
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State | GA
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Zip | 30342-0634
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER AND PRINCIPAL CONSULTANT
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Name | DR. CAROLINE M. BRACKETTE
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Credential |
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Telephone | 404-303-1864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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