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KRYSTAL BRAASE WAIVER

Behavioral Health & Social Service Providers Social Worker

Provider NPI: 1184105884

Provider Information:
 KRYSTAL  BRAASE WAIVER
Gender: F
Not Sole Proprietor

Practice Location:
25 W MAIN ST  CONWAY, NH 03818-6142 US
Tel: 603-447-2111  Fax: --

Business Mailing Address:
87 WASHINGTON ST  CONWAY, NH 03818-6044 US
Tel: 603-447-3347  Fax: --

NPI Information:
NPI: 1184105884
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y104100000XBehavioral Health & Social Service Providers
Social Worker

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 104100000X

Type:

Classification:



Definition:



MEDICAL JOBS NH - Page 1

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