Individual
MS. MARIANNE BAILEY BRANHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2716 FORUM BLVD., SUITE 4B, COLUMBIA, MO 65203-5450
(573) 817-9611
Mailing address
801 SECOND STREET, ROCHEPORT, MO 65279-9011
(573) 673-6799
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW005043
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497961037
—
MO
Enumeration date
11/01/2006
Last updated
10/14/2011
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