Brazell, Myra J

Brazell, Myra J is an sole proprietor health care provider with primary practice located at 5201 Raymond St , Orlando FL 32803-8208. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Brazell, Myra J can be contacted via phone (407) 621-2639.

Contact Information

Primary practice address
5201 Raymond St Orlando FL 32803-8208
Phone: (407) 621-2639
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW 6899 Florida

Profile Details

NPI number 1619925302
LBN Legal business name Brazell, Myra J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2006
Last updated Dec 26th, 2012 - about 12 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 1619925302 NPPES
Florida MEDICAID 767024900

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