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Organization

MARIANNE B. BRANHAM, LCSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIANNE BRANHAM (SOLE OWNER)
(573) 817-9611
Entity
Organization

Contact information

Practice address
2716 FORUM BLVD., SUITE 4B, COLUMBIA, MO 65203
(573) 817-9611
(573) 817-9610
Mailing address
2716 FORUM BLVD STE 4B, COLUMBIA, MO 65203-5450
(573) 817-9611
(573) 817-9610

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW005043
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10849131
CAQH
MO
01
1124105622
NPI
MO
Enumeration date
09/15/2017
Last updated
07/21/2022
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