Most Relevant Information
Provider Data
| NPI Number: | 1003073370 |
| Provider Name: | LORRAINE BRAXTON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2008 |
| Last Updated: | 05/22/2008 |
Provider Practice Location
4900 WYALUSING AVE
PHILADELPHIA
PA
191315127
Practice Location Phone/Fax
| Phone: | 2154737033 |
| Fax: |
Provider Mailing Location
1328 E CLIVEDEN ST
PHILADELPHIA
PA
191193948
Provider Mailing Phone/Fax
| Phone: | 2154737033 |
| Fax: |