Provider Demographics
NPI:1710132402
Name:BRAKKE-HOEHLE ENT.
Entity Type:Organization
Organization Name:BRAKKE-HOEHLE ENT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRAKKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:205-979-0699
Mailing Address - Street 1:2310 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2426
Mailing Address - Country:US
Mailing Address - Phone:205-979-0699
Mailing Address - Fax:205-979-0699
Practice Address - Street 1:1025 MONTGOMERY HWY
Practice Address - Street 2:SUITE 203
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-2805
Practice Address - Country:US
Practice Address - Phone:205-979-0699
Practice Address - Fax:205-979-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL518251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health