Provider Information for 1225438526
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VANEKA SHAUNTAE BRASWELL LCSW
Other Names:Professional Name:VANEKA PATRICK LCSWSex: Female
NPI: 1225438526
Last Updated: 2022-12-05
Certification Date: 2022-12-05
Certification Date: 2022-12-05
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1225438526 | ||||||||
| Enumeration Date | 2014-08-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4110 MUNSON DR CHARLOTTE, NC 28215-4569 United States Phone: 910-583-2844 | Fax: | ||||||||
| Primary Practice Address | 4110 MUNSON DR CHARLOTTE, NC 28215-4569 United States Phone: 910-583-2844 | Fax: | ||||||||
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