Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003222902 |
---|---|
Provider Name | Ms. Ciara Braun |
First Address | Shelby Township, MI 48315-3140 |
Second Address | Shelby Township, MI 48315-3140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2014 |
Last Update Date | 11/07/2014 |