| Doctor Name: | MRS. GRACE E BRANHAM |
| NPI Number: | 1154484962 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMFT |
| License Number: | 183-124 |
| Business Practice Address: | 1035 N Main St Rice Lake, WI - 548681260 |
| Business Phone Number: | 7152344313 |
| Business Fax Number: | |
| Mailing Address: | 1035 N Main St, RICE LAKE |
| State: | WI |
| Postal Code: | 548681260 |
| Phone Number: | 7152347477 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 183-124 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |