Individual
MS. DANIELLE BLYTHE BRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1 LAWSON LN STE 310, BURLINGTON, VT 05401-8445
(802) 343-8534
Mailing address
173 PATCHEN RD, SOUTH BURLINGTON, VT 05403-5741
(802) 865-9612
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890001068
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012584
—
VT
Enumeration date
03/09/2007
Last updated
07/08/2007
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