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Organization
BRAVO MENTAL WELLNESS PLLC
Active
Organization
BRAVO MENTAL WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SASHA BRAVO MSN (PMHNP)
(828) 776-5155
Entity
Organization
Contact information
Practice address
174 MINE LAKE CT STE 200, RALEIGH, NC 27615-6417
(919) 769-1910
(919) 214-5388
Mailing address
921 E BROAD ST # 1065, FUQUAY VARINA, NC 27526-1960
(828) 776-5155
(919) 214-1327
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5014097
NORTH CAROLINA BOARD OF NURSING NP LICENSE NUMBER
NC
Enumeration date
03/06/2023
Last updated
04/12/2023
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