Individual
JOHN D BRAUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
001722
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25840047
BLUE CROSS BLUE SHIELD
MO
05
—
493863203
—
MO
Enumeration date
12/16/2005
Last updated
04/30/2018
Update your record
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