Provider Demographics
NPI:1902478126
Name:PHEBE BRAKO-OWUSU, LMFT, PLLC
Entity Type:Organization
Organization Name:PHEBE BRAKO-OWUSU, LMFT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAKO-OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:253-778-6636
Mailing Address - Street 1:1115 TACOMA AVE S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-2005
Mailing Address - Country:US
Mailing Address - Phone:253-778-6636
Mailing Address - Fax:
Practice Address - Street 1:1115 TACOMA AVE S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-2005
Practice Address - Country:US
Practice Address - Phone:253-778-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty