Provider Demographics
NPI:1952429722
Name:BRAEN, ERIC ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:BRAEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10216 PEPPERHILL LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-3835
Mailing Address - Country:US
Mailing Address - Phone:804-840-6184
Mailing Address - Fax:804-592-2667
Practice Address - Street 1:13801 VILLAGE MILL DR STE 105
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4382
Practice Address - Country:US
Practice Address - Phone:804-840-6184
Practice Address - Fax:804-592-2667
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002140103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical