Provider Demographics
NPI:1609922814
Name:BRATCHER, WALTER E SR (EDD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:E
Last Name:BRATCHER
Suffix:SR
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42302-0532
Mailing Address - Country:US
Mailing Address - Phone:270-688-9003
Mailing Address - Fax:
Practice Address - Street 1:401 W LEGION BLVD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-6346
Practice Address - Country:US
Practice Address - Phone:270-688-9003
Practice Address - Fax:270-688-8655
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0682103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling