Brainard, Marythelma
Brainard, Marythelma is an sole proprietor health care provider with primary practice located at 2128 Silver Ave Se , Albuquerque NM 87106-4010. She recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as her primary health care specialty. Brainard, Marythelma can be contacted via phone (505) 242-7671.Contact Information
Primary practice address
2128 Silver Ave Se
Albuquerque NM 87106-4010
Phone: (505) 242-7671
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 369 | New Mexico |
Profile Details
| NPI number | 1124187075 |
|---|---|
| LBN Legal business name | Brainard, Marythelma |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124187075 | NPPES |
| New Mexico | MEDICAID | N6580 |
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