| Doctor Name: | DR. PHYLLIS ARNELLA BRAXTON |
| NPI Number: | 1073797650 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | LC-1071 |
| Business Practice Address: | 8957 Edmonston Rd Suite M Greenbelt, MD - 207701005 |
| Business Phone Number: | 2406674290 |
| Business Fax Number: | 7035639698 |
| Mailing Address: | 41 Morton Rd, FALMOUTH |
| State: | VA |
| Postal Code: | 224051488 |
| Phone Number: | 2404230061 |
| Fax Number: | 7035639698 |
| NPI Enumeration Date: | 12/19/2007 |
| NPI Last Update Date: | 03/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC-1071 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |