Individual
MICHAEL WALTER BRAGG SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA/CPRS
Contact information
Practice address
2611 WAYNE AVE BLDG 64, DAYTON, OH 45420-1833
(937) 256-7801
Mailing address
2125 SIDNEYWOOD DR APT E, DAYTON, OH 45449-2671
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.188453
OH
175T00000X
Peer Specialist
Primary
APS.004519
OH
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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