Provider Demographics
NPI:1821632514
Name:BRAILER, CLAIRE (RD, LN)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:BRAILER
Suffix:
Gender:F
Credentials:RD, LN
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:
Other - Last Name:MAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LN
Mailing Address - Street 1:2612 BEARTOOTH DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1204
Mailing Address - Country:US
Mailing Address - Phone:406-544-6585
Mailing Address - Fax:
Practice Address - Street 1:1315 GOLDEN VALLEY CIR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6746
Practice Address - Country:US
Practice Address - Phone:406-238-6206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-NUTR-LIC-67852133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered