Individual
ASHLEY BRAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
310 4TH AVE S, SUITE 5010 PMB 92562, MINNEAPOLIS, MN 55415-1053
(612) 268-2493
Mailing address
310 4TH AVE S, SUITE 5010 PMB 92562, MINNEAPOLIS, MN 55415-1053
(612) 268-2493
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
02392401
NY
103T00000X
Psychologist
115546
IA
103T00000X
Psychologist
Primary
LP6810
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02392401
LICENSE NUMBER
NY
01
—
115546
LICENSE NUMBER
IA
01
—
2019037969
PROVISIONAL LICENSE NUMBER (MO)
MO
01
—
LP6810
LICENSE NUMBER
MN
Enumeration date
08/31/2020
Last updated
11/11/2024
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