Provider Demographics
NPI:1093172827
Name:TERRY N BRAUN COUNSELING LLC
Entity Type:Organization
Organization Name:TERRY N BRAUN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BADGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-347-4514
Mailing Address - Street 1:1042 14TH AVE E STE 210
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3363
Mailing Address - Country:US
Mailing Address - Phone:701-799-6258
Mailing Address - Fax:
Practice Address - Street 1:1042 14TH AVE E STE 210
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3363
Practice Address - Country:US
Practice Address - Phone:701-799-6258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center