Provider Demographics
NPI:1174363808
Name:BRAUSEN, JOSALIN ROSE
Entity type:Individual
Prefix:
First Name:JOSALIN
Middle Name:ROSE
Last Name:BRAUSEN
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 1:5505 41ST AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2215
Mailing Address - Country:US
Mailing Address - Phone:715-781-9017
Mailing Address - Fax:
Practice Address - Street 1:4756 BANNING AVE STE 210
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-3206
Practice Address - Country:US
Practice Address - Phone:612-454-1656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health