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1548988645
TIA PATRICE BRAXTON
LOUISVILLE, KY
NPI
1548988645
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: KY 3018206)
Enumeration Date
2022-08-16
Last Update Date
2022-08-19
Business Address
TIA PATRICE BRAXTON
6540 OUTER LOOP STE 6
LOUISVILLE, KY 40228-2000
Phone number: 502-255-1925
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Mailing Address
TIA PATRICE BRAXTON
8813 ARISTIDES DR
LOUISVILLE, KY 40258-1735
Phone number: 502-999-2855
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