Individual
LISA BRASWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1033 HAZELMIST DR, WAKE FOREST, NC 27587-9254
(984) 292-4515
Mailing address
6330 FALLS OF NEUSE RD STE 106B, RALEIGH, NC 27615-6810
(984) 292-4515
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
12/29/2022
Last updated
12/30/2022
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