Individual
VIRGINIA KATHERINE BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
113 N 4TH ST, PALATKA, FL 32177-3722
(386) 546-3426
Mailing address
113 N 4TH ST, PALATKA, FL 32177-3722
(386) 546-3426
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT 2705
FL
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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