Doctor Name: | MISS MONAE BRANHAM |
NPI Number: | 1033200357 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | |
Business Practice Address: | Region Iii Mental Health Center 2434 South Eason Blvd Tupelo, MS - 388046942 |
Business Phone Number: | 6628441717 |
Business Fax Number: | 6626806416 |
Mailing Address: | 60114 Hadaway Bottom Road, SMITHVILLE |
State: | MS |
Postal Code: | 38870 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |