Individual
JEREMY ALAN BRAGALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
780 N CHURCH ST, HAZLETON, PA 18201-2901
(570) 401-9514
Mailing address
780 N CHURCH ST, HAZLETON, PA 18201-2901
(570) 401-9514
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW130256
PA
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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