Organization
BENJAMIN BRAAKSMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN BRAAKSMA (OWNER)
(206) 945-0648
Entity
Organization
Contact information
Practice address
1115 BETHEL RD, COLUMBUS, OH 43220-2690
(206) 945-0648
(206) 834-6734
Mailing address
1115 BETHEL RD, COLUMBUS, OH 43220-2690
(206) 945-0648
(206) 834-6734
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E.2303894
LICENSE
OH
01
—
LH60891645
LICENSE
WA
Enumeration date
05/28/2020
Last updated
09/24/2024
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