Individual
MRS. SUSAN DIANE BRANAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
594
OK
101YM0800X
Mental Health Counselor
2913
OK
1041C0700X
Clinical Social Worker
Primary
2913
OK
106H00000X
Marriage & Family Therapist
2913
OK
Other
Enumeration date
08/18/2009
Last updated
10/24/2012
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