Provider Demographics
NPI:1619927381
Name:BRAUCHI, PAMELA LOUISE (LPR, ATR)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:LOUISE
Last Name:BRAUCHI
Suffix:
Gender:F
Credentials:LPR, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5806 S ATLANTA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7530
Mailing Address - Country:US
Mailing Address - Phone:918-749-0944
Mailing Address - Fax:918-749-0286
Practice Address - Street 1:5525 E 51ST ST
Practice Address - Street 2:SUITE #400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7461
Practice Address - Country:US
Practice Address - Phone:918-388-6279
Practice Address - Fax:918-388-6456
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC03-195101YP2500X
OK3057101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional