Individual
MYRA BRAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC-IT, SAC-IT
Contact information
Practice address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-6113
Mailing address
1541 ANNEX RD, JEFFERSON, WI 53549-9803
(920) 674-3105
(920) 674-6113
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2731-226
WI
Other
Enumeration date
03/16/2016
Last updated
06/20/2016
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