Provider Demographics
NPI:1891083309
Name:BRAVO-CAMELO, ANA CRISTINA
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:CRISTINA
Last Name:BRAVO-CAMELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:BRAVO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LMHCA
Mailing Address - Street 1:7981 168TH AVE NE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0911
Mailing Address - Country:US
Mailing Address - Phone:425-829-8089
Mailing Address - Fax:
Practice Address - Street 1:7981 168TH AVE NE
Practice Address - Street 2:SUITE 202
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0911
Practice Address - Country:US
Practice Address - Phone:425-829-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60159960101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health