Braxton, Loretta Elaine

Braxton, Loretta Elaine is an sole proprietor health care provider with primary practice located at 1415 W Nc Highway 54 Ste 113, Durham NC 27707-5577. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Braxton, Loretta Elaine can be contacted via phone (919) 401-8090.

Contact Information

Primary practice address
1415 W Nc Highway 54 Ste 113 Durham NC 27707-5577
Phone: (919) 401-8090
Fax: (919) 401-8091
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1679 North Carolina

Profile Details

NPI number 1689658072
LBN Legal business name Braxton, Loretta Elaine
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated Jul 8th, 2007 - about 18 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 1689658072 NPPES
North Carolina MEDICAID 6000707

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