MEDICARE: MARY KATHRYN BRAMMER MS, PLPC

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	101YP2500X	Professional Counselor	2013033673	MO

General Provider Information

NPI Number	:	1336575984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY KATHRYN BRAMMER MS, PLPC

Provider Business Mailing Address
First Line	:	1835 S STEWART AVE
Second Line	:	PLAZA 3 SUITE 100A
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-2581
Country	:	US
Telephone Number	:	417-773-8941
Fax Number	:

Provider Business Practice Location Address
First Line	:	2046 S WELLINGTON AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-2142
Country	:	US
Telephone Number	:	417-773-8941
Fax Number	:

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

Provider Enumeration Date	:	09/15/2013
Last Update Date	:	09/15/2013

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