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JAMES BRAITH PHD, LCP

Clinical Neuropsychologist

Mechanicsville, Virginia

Provider NPI: 1104865427

Provider Information:
 JAMES  BRAITH PHD, LCP
Gender: M
Not Sole Proprietor

Practice Location:
8254 ATLEE RD  MECHANICSVILLE, VA 23116 US
Tel: 804-342-4300  Fax: 804-342-4316

Business Mailing Address:
8254 ATLEE RD  MECHANICSVILLE, VA 23116 US
Tel: 804-342-4300  Fax: 804-342-4316

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
VI0810001961

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM110021VA01
AETNA7613246VA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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