Provider Demographics
NPI:1366332207
Name:BRAITHWAITE-BERRAL, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:BRAITHWAITE-BERRAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:BRAITHWAITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AMFT
Mailing Address - Street 1:51 W END TRL UNIT 404
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-5014
Mailing Address - Country:US
Mailing Address - Phone:484-641-7595
Mailing Address - Fax:
Practice Address - Street 1:925 BERKSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1229
Practice Address - Country:US
Practice Address - Phone:484-516-2330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAMF000076106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist