Brannon, Marilyn E
Brannon, Marilyn E is an sole proprietor health care provider with primary practice located at 534 Trejo Street Suite 100, Rexburg ID 83440. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Counseling. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Brannon, Marilyn E can be contacted via phone (208) 356-3776.Contact Information
Primary practice address
534 Trejo Street Suite 100
Rexburg ID 83440
Phone: (208) 356-3776
Fax: (208) 356-9498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY 229 | Idaho |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | PSY 229 | Idaho |
Profile Details
| NPI number | 1497889968 |
|---|---|
| LBN Legal business name | Brannon, Marilyn E |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 15th, 2007 |
| 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 | 1497889968 | NPPES |
| Idaho | Other | 0010016770 | REGENCE BLUE SHIELD OF ID |
| Idaho | Other | N2290 | REGENCE BLUE SHIELD OF ID |
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