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Individual
THOMAS BRACKENDORFF
Active
Individual
THOMAS BRACKENDORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
86381
TX
101YM0800X
Mental Health Counselor
86381
TX
101YP2500X
Professional Counselor
Primary
86381
TX
Other
Enumeration date
07/21/2021
Last updated
04/21/2024
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