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NPI Code Detail

MEDICARE: MRS. PATRICIA CORELLA BRACKIN TLPC

MEDICARE:  MRS. PATRICIA CORELLA BRACKIN  TLPC
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
1101YP2500XProfessional Counselor2282KS

General Provider Information

NPI Number : 1669751665
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA CORELLA BRACKIN TLPC
Provider Business Mailing Address
First Line : 2121 BROOKE BND
Second Line :
City : JUNCTION CITY
State : KS
Zip : 66441-1415
Country : US
Telephone Number : 785-226-0696
Fax Number :
Provider Business Practice Location Address
First Line : 838 S WASHINGTON ST STE A
Second Line :
City : JUNCTION CITY
State : KS
Zip : 66441-3826
Country : US
Telephone Number : 785-226-0696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2011
Last Update Date : 08/08/2011

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Directions to “ MRS. PATRICIA CORELLA BRACKIN TLPC” Practice Location

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