Individual
LORI BRAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
5815 BROADWAY AVE, GREAT BEND, KS 67530-3123
(620) 792-2544
Mailing address
5815 BROADWAY AVE, GREAT BEND, KS 67530-3197
(620) 792-2544
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2736
KS
1041C0700X
Clinical Social Worker
Primary
4697
KS
Other
Enumeration date
07/13/2011
Last updated
11/14/2019
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