Provider Demographics
NPI:1548441363
Name:BRATLY, MARIA LUISA (BA, MS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LUISA
Last Name:BRATLY
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8131 GARDEN GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1439
Mailing Address - Country:US
Mailing Address - Phone:818-342-3371
Mailing Address - Fax:
Practice Address - Street 1:8131 GARDEN GROVE AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-1439
Practice Address - Country:US
Practice Address - Phone:818-342-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator