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:
Health care specialties
| Specialty | Code | License # | 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 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 | 1689658072 | NPPES |
| North Carolina | MEDICAID | 6000707 |
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