Provider Demographics
NPI:1396883179
Name:HINES, BARBARA BRAYTON (MS MAR)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:BRAYTON
Last Name:HINES
Suffix:
Gender:F
Credentials:MS MAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W COLLEGE
Mailing Address - Street 2:WELLNESS COUNSELING CENTER SUITE 815
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-733-1992
Mailing Address - Fax:920-733-1866
Practice Address - Street 1:103 W COLLEGE
Practice Address - Street 2:WELLNESS COUNSELING CENTER SUITE 815
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-733-1992
Practice Address - Fax:920-733-1866
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2474125101YM0800X
WI184124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist