Individual
DR. JOHANA KASHIWA BRAKELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5 SOUTH ST, MIDDLEBURY, VT 05753-1319
(802) 388-1002
(802) 388-1004
Mailing address
5 SOUTH ST, MIDDLEBURY, VT 05753-1319
(802) 388-2194
(802) 388-1004
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
0420006226
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005148
BLUE CROSS & BLUE SHIELD
VT
05
—
0005148
—
VT
01
—
26V004
MVP INSURANCE
VT
01
—
481306
CIGNA INSURANCE
VT
Enumeration date
09/02/2006
Last updated
07/08/2007
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