MEDICARE: BRIANNA G VOLLBRACHT LMSW

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	LMSW13700	KS

General Provider Information

NPI Number	:	1942045331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA G VOLLBRACHT LMSW

Provider Business Mailing Address
First Line	:	2237 W MAPLE ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67213-2719
Country	:	US
Telephone Number	:	316-928-9034
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 N WACO AVE STE 11
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67203-3971
Country	:	US
Telephone Number	:	316-721-8118
Fax Number	:

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

Provider Enumeration Date	:	06/27/2024
Last Update Date	:	06/27/2024

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