Individual
DR. JAMES BRAGONIER GILLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
127 STATE STREET, SUITE 7, NEWTOWN, PA 18940
(215) 968-5151
Mailing address
800 WEST STATE STREET, SUITE 103, DOYLESTOWN, PA 18901
(215) 431-6987
(267) 685-4292
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PS004175-L
PA
103T00000X
Psychologist
010299
NY
103T00000X
Psychologist
1838
NJ
103T00000X
Psychologist
Primary
PS-004175-L
PA
Other
Enumeration date
05/19/2007
Last updated
11/29/2010
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