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FADRA BRANSON MHPP

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1588957815

Individual Registrant:
 FADRA  BRANSON MHPP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
121 SAWGRASS PT  HARRISON, AR 72601-3072 US
Tel: 970-391-3871  Fax: 870-391-3874

Contact information for business:
3352 N FUTRALL DR  FAYETTEVILLE, AR 72703-4057 US
Tel: 479-521-1427  Fax: 479-521-6520

Registration Information:
NPI: 1588957815
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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