Provider Demographics
NPI:1831508407
Name:ROBIN PERRY BRAUN
Entity type:Organization
Organization Name:ROBIN PERRY BRAUN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:PERRY
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCI
Authorized Official - Phone:386-212-5221
Mailing Address - Street 1:5420 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-5046
Mailing Address - Country:US
Mailing Address - Phone:386-212-5221
Mailing Address - Fax:
Practice Address - Street 1:5420 TREMONT ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-5046
Practice Address - Country:US
Practice Address - Phone:386-212-5221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71536101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty