MEDICARE: MISS LENORE NATALIA BRAFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1164536199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS LENORE NATALIA BRAFORD

Provider Business Mailing Address
First Line	:	167 MORGAN ST
Second Line	:
City	:	OBERLIN
State	:	OH
Zip	:	44074-1513
Country	:	US
Telephone Number	:	440-774-2215
Fax Number	:

Provider Business Practice Location Address
First Line	:	26694 CHAPEL HILL DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-1812
Country	:	US
Telephone Number	:	440-716-0501
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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