Individual
CORY BRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, AAC
Contact information
Practice address
910 16TH AVE STE 120, LONGVIEW, WA 98632-2374
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61479683
WA
Other
Enumeration date
08/28/2023
Last updated
10/18/2023
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