Individual
TYREA D BRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCPRS,
Contact information
Practice address
25201 CHAGRIN BLVD STE 390, BEACHWOOD, OH 44122-5637
(216) 910-9015
(216) 910-9015
Mailing address
520 E 7TH ST, MANCHESTER, OH 45144-1562
(606) 375-8957
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0002260
OH
Other
Enumeration date
03/16/2021
Last updated
01/20/2022
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