Brawley, Tora L

Brawley, Tora L is an individual health care provider with primary practice located at 15 Medical Park Rd Suite 103, Columbia SC 29203-8003. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Forensic is her primary health care specialty. Brawley, Tora L can be contacted via phone (803) 434-4300.

Contact Information

Primary practice address
15 Medical Park Rd Suite 103 Columbia SC 29203-8003
Fax: (803) 434-4277
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 752 South Carolina
Behavioral Health & Social Service Providers / Forensic 103TF0200X 752 South Carolina

Profile Details

NPI number 1235190653
LBN Legal business name Brawley, Tora L
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Dec 2nd, 2008 - about 16 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 1235190653 NPPES
South Carolina MEDICAID PS0311

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