Provider Demographics
NPI:1164453239
Name:BRANEM, ANN JOSEPHINE
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:JOSEPHINE
Last Name:BRANEM
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 1:3909 RESERVE DR
Mailing Address - Street 2:APT 621
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-8200
Mailing Address - Country:US
Mailing Address - Phone:850-656-8865
Mailing Address - Fax:850-222-8865
Practice Address - Street 1:3909 RESERVE DR
Practice Address - Street 2:APT 621
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-8200
Practice Address - Country:US
Practice Address - Phone:850-656-8865
Practice Address - Fax:850-222-8865
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional