Individual
RITA JEAN BRAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CADC-D
Contact information
Practice address
888 THACKERAY TRL, 105, OCONOMOWOC, WI 53066-4342
(262) 542-3255
(262) 567-5451
Mailing address
1230 CORPORATE CENTER DR, STE 100, OCONOMOWOC, WI 53066-4883
(262) 542-3255
(262) 567-5451
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6612-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13350
ALCOHOL & DRUG COUNSELOR
WI
05
—
39788800
—
WV
Enumeration date
08/22/2006
Last updated
06/29/2018
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