Individual
ANGELA BRAGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
11002 W PARK PL, MILWAUKEE, WI 53224-3615
(414) 949-0758
Mailing address
11002 W PARK PL, MILWAUKEE, WI 53224-3615
(414) 949-0758
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4575-226
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
WI
Enumeration date
02/17/2020
Last updated
02/17/2020
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