Provider Demographics
NPI:1083373575
Name:BRAUNSTEIN, AVIGYLE
Entity Type:Individual
Prefix:
First Name:AVIGYLE
Middle Name:
Last Name:BRAUNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 DATE ST APT 22I
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1190
Mailing Address - Country:US
Mailing Address - Phone:808-304-1227
Mailing Address - Fax:
Practice Address - Street 1:2916 DATE ST APT 22I
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1190
Practice Address - Country:US
Practice Address - Phone:808-304-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-11
Last Update Date:2021-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty