Individual
MICHELLE WRAGGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLADC, PLMHP
Contact information
Practice address
1811 W 2ND ST STE 450, GRAND ISLAND, NE 68803-5473
(308) 384-4405
Mailing address
1811 W 2ND ST STE 450, GRAND ISLAND, NE 68803-5473
(308) 384-4405
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P1372
NE
101YM0800X
Mental Health Counselor
P10782
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470522836
—
NE
Enumeration date
04/15/2014
Last updated
01/27/2016
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