Organization
BONNIE LEE BRAGLIA LPC-S,LMFT,CCDVC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE LEE BRAGLIA BSN,LPC-S,LMFT,CCDVC (PSYCHOTHERAPIST,SUPERVISOR LPC TX,)
(361) 774-0293
Entity
Organization
Contact information
Practice address
4659 EVERHART RD. SUITE 109, CORPUS CHRISTI, TX 78411
(361) 774-0293
(361) 452-0029
Mailing address
3434 ALAMEDA ST., CORPUS CHRISTI, TX 78411
(361) 774-0293
(361) 452-0029
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2914
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YP2500X
LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR-STATE OF TEXAS
TX
01
—
101YP2500X
LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR-STATE OF TEXAS
—
01
—
103TF0200X
CLINICALLY CERTIFIED DOMESTIC VIOLENCE COUNSELOR, F17949
TX
01
—
106HOOOOOX
MARRIAGE & FAMILY THERAPIST
TX
01
—
F17949
FORENSIC COUNSELOR CLINICALLY CERTIFIED DOMESTIC VIOLENCE COUNSELOR
TX
Enumeration date
05/07/2015
Last updated
05/07/2015
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