MEDICARE: MARIE G LABRANCHE LMFT

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	103TP2701X	Group Psychotherapy Psychologist	3693	FL

General Provider Information

NPI Number	:	1699325829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE G LABRANCHE LMFT

Provider Business Mailing Address
First Line	:	2944 HIDDEN HILLS RD APT 1602
Second Line	:
City	:	WEST PALM BCH
State	:	FL
Zip	:	33411-4827
Country	:	US
Telephone Number	:	561-932-3027
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 VILLAGE SQUARE XING STE 105
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4531
Country	:	US
Telephone Number	:	561-463-3078
Fax Number	:

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

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	09/19/2019

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