Bracciale, Marie

Bracciale, Marie is an sole proprietor health care provider with primary practice located at 600 Elizabeth Pl , South Daytona FL 32119-2824. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Bracciale, Marie can be contacted via phone (386) 322-6180.

Contact Information

Primary practice address
600 Elizabeth Pl South Daytona FL 32119-2824
Phone: (386) 322-6180
Fax: (386) 506-0008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2517L CAP Florida
Behavioral Health & Social Service Providers / School 101YS0200X 481172 DOE Florida
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MT 1604 Florida

Profile Details

NPI number 1134599921
LBN Legal business name Bracciale, Marie
Credentials PH.D. , LMFT, CAP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 6th, 2015
Last updated Oct 6th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134599921 NPPES
Florida MEDICAID 765941500

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