Doctor Name: | MS. GINA RACHELE BRAZZLE |
NPI Number: | 1003922857 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, BCD |
License Number: | 05504 |
Business Practice Address: | 4614 N I H 35 Austin, TX - 787513401 |
Business Phone Number: | 5129724900 |
Business Fax Number: | 5129724940 |
Mailing Address: | 4614 N I H 35, AUSTIN |
State: | TX |
Postal Code: | 787513401 |
Phone Number: | 5129724900 |
Fax Number: | 5129724940 |
NPI Enumeration Date: | 08/22/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 05504 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |