Organization
FOUR CORNERS MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A BRAUNSTEIN DO (OWNER)
(970) 382-6690
Entity
Organization
Contact information
Practice address
2855 MAIN AVE, SUITE A105, DURANGO, CO 81301
(970) 382-6690
(970) 382-0207
Mailing address
2855 MAIN AVE, SUITE A105, DURANGO, CO 81301
(970) 382-6690
(970) 382-0207
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
40471
CO
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
09/26/2006
Last updated
06/22/2011
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