Provider Demographics
NPI:1659311322
Name:BRATCHER, ERIC R
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:BRATCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4246 CORTONA CV
Mailing Address - Street 2:APT. #302
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6350
Mailing Address - Country:US
Mailing Address - Phone:407-665-3265
Mailing Address - Fax:407-665-3312
Practice Address - Street 1:400 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5496
Practice Address - Country:US
Practice Address - Phone:407-665-3265
Practice Address - Fax:407-665-3312
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor