Individual
DR. JOHN H. BRACCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1401 E LANSING DR STE 111, EAST LANSING, MI 48823-2992
(517) 332-0153
(517) 332-2960
Mailing address
1401 E LANSING DR STE 111, EAST LANSING, MI 48823-2992
(517) 332-0153
(517) 332-2960
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
#6301001831
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005-38247204200
CIGNA
MI
01
—
620C3-4546
BCBS
MI
Enumeration date
01/15/2007
Last updated
07/08/2007
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