| Doctor Name: | BETH LOUISE BRANTNER |
| NPI Number: | 1023316874 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.ED./LAC/LPCC |
| License Number: | 348-3-1-96-108 |
| Business Practice Address: | 4227 9th Ave Sw Fargo, ND - 581032018 |
| Business Phone Number: | 7012826561 |
| Business Fax Number: | 7013738674 |
| Mailing Address: | 4227 9th Ave Sw, FARGO |
| State: | ND |
| Postal Code: | 581032018 |
| Phone Number: | 7012826561 |
| Fax Number: | 7013738674 |
| NPI Enumeration Date: | 03/03/2011 |
| NPI Last Update Date: | 03/03/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 348-3-1-96-108 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ND |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |