Basic Information
| Provider Information | |||||||||
| NPI: | 1003016395 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRAWLEY | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MFTI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 S MAIN ST STE 112 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939012392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961575 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1270 NATIVIDAD RD RM 200 | ||||||||
| Address2: | |||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939063122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317554510 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2007 | ||||||||
| LastUpdateDate: | 07/24/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | MFTI 41954 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.