Individual
DR. E. MERLE BRAGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
178 MIDDLE ST, SUITE 300, PORTLAND, ME 04101-4075
(207) 772-1570
(207) 772-2670
Mailing address
178 MIDDLE ST, SUITE 300, PORTLAND, ME 04101-4075
(207) 772-1570
(207) 772-2670
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS742
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170033
ANTHEM BCBS
ME
01
—
373948
VALUE OPTIONS
ME
01
—
E007054
CHAMPUS
ME
Enumeration date
06/01/2007
Last updated
07/08/2007
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