Individual
CHAD BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 WAKE FOREST RD, RALEIGH, NC 27609-6879
(919) 865-8710
Mailing address
4000 WAKE FOREST RD, RALEIGH, NC 27609-6879
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P011888
NC
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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