Individual
JOANN BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
9703
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9489018000
—
WV
Enumeration date
04/16/2008
Last updated
04/16/2008
Update your record
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