Provider Demographics
NPI:1427927748
Name:BRANCH, EMMA GRACE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:GRACE
Last Name:BRANCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 W LAWRENCE HARRIS HWY # 52
Mailing Address - Street 2:
Mailing Address - City:SLOCOMB
Mailing Address - State:AL
Mailing Address - Zip Code:36375-5352
Mailing Address - Country:US
Mailing Address - Phone:334-618-3302
Mailing Address - Fax:
Practice Address - Street 1:426 W LAWRENCE HARRIS HWY # 52
Practice Address - Street 2:
Practice Address - City:SLOCOMB
Practice Address - State:AL
Practice Address - Zip Code:36375-5352
Practice Address - Country:US
Practice Address - Phone:334-618-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL25-484706Other25-484706