Provider Demographics
NPI:1063707370
Name:BRAUNBERGER, KERI A (LPC)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:A
Last Name:BRAUNBERGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:RANCHESTER
Mailing Address - State:WY
Mailing Address - Zip Code:82839-0010
Mailing Address - Country:US
Mailing Address - Phone:307-751-2648
Mailing Address - Fax:
Practice Address - Street 1:16 ASPEN COURT
Practice Address - Street 2:
Practice Address - City:RANCHESTER
Practice Address - State:WY
Practice Address - Zip Code:82839
Practice Address - Country:US
Practice Address - Phone:307-751-2648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1320101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor