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NPI Code Detail

MEDICARE: SHELLEY DELANE BRAYMEN LPCA

MEDICARE:   SHELLEY DELANE BRAYMEN  LPCA
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
1101YM0800XMental Health Counselor90535TX

General Provider Information

NPI Number : 1942912720
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY DELANE BRAYMEN LPCA
Provider Business Mailing Address
First Line : 4541 KNOLL RIDGE DR
Second Line :
City : ALEDO
State : TX
Zip : 76008-5242
Country : US
Telephone Number : 817-312-4322
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S UNIVERSITY DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5737
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2022
Last Update Date : 01/06/2023

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Directions to “ SHELLEY DELANE BRAYMEN LPCA” Practice Location

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