Provider Demographics
NPI:1083890149
Name:BRAUHN, MARY ANN E (MS LPCC)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:E
Last Name:BRAUHN
Suffix:
Gender:F
Credentials:MS LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 SIMS
Mailing Address - Street 2:STE 208
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601
Mailing Address - Country:US
Mailing Address - Phone:701-483-9600
Mailing Address - Fax:701-483-9602
Practice Address - Street 1:135 SIMS
Practice Address - Street 2:STE 208
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601
Practice Address - Country:US
Practice Address - Phone:701-483-9600
Practice Address - Fax:701-483-9602
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2921119476101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health