Individual
MR. DOUGLAS ROBERT BRATHOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2900 VETERANS WAY, VIERA, FL 32940-8007
(321) 637-3788
Mailing address
2900 VETERANS WAY, VETERANS HEALTH ADMINISTRATION- VA OPC HCHV, VIERA, FL 32940
(321) 637-3788
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW10586
FL
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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