| Organization Name: | BRAZOS VALLEY MENTAL HEALTH AND WELLNESS |
| NPI Number: | 1063874683 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHERRY HAFERKAMP (CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 2554 E Villa Maria Rd Bryan |
| State: | TX US |
| Postal Code: | 778022037 |
| Phone Number: | 9797771683 |
| Fax Number: | |
| NPI Enumeration Date: | 03/23/2016 |
| NPI Last Update Date: | 03/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 37193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |