| Bonnie Lee Braglia Lpc-s,lmft,ccdvc | |
|
4659 Everhart Rd. Suite 109 Corpus Christi TX 78411 | |
| (361) 774-0293 | |
| (361) 452-0029 |
| Full Name | Bonnie Lee Braglia Lpc-s,lmft,ccdvc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4659 Everhart Rd. Suite 109, Corpus Christi, Texas |
| Authorized Official Name and Position | Bonnie Lee Braglia (PSYCHOTHERAPIST,SUPERVISOR LPC TX,) |
| Authorized Official Contact | 3617740293 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bonnie Lee Braglia Lpc-s,lmft,ccdvc 3434 Alameda St. Corpus Christi TX 78411 Ph: (361) 774-0293 | Bonnie Lee Braglia Lpc-s,lmft,ccdvc 4659 Everhart Rd. Suite 109 Corpus Christi TX 78411 Ph: (361) 774-0293 |
| NPI Number | 1306224605 |
|---|---|
| Provider Enumeration Date | 05/07/2015 |
| Last Update Date | 05/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306224605 | NPI | - | NPPES |
| 106HOOOOOX | Other | TX | MARRIAGE & FAMILY THERAPIST |
| 103TF0200X | Other | TX | CLINICALLY CERTIFIED DOMESTIC VIOLENCE COUNSELOR, F17949 |
| F17949 | Other | TX | FORENSIC COUNSELOR CLINICALLY CERTIFIED DOMESTIC VIOLENCE COUNSELOR |
| 101YP2500X | Other | LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR-STATE OF TEXAS | |
| 101YP2500X | Other | TX | LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR-STATE OF TEXAS |
| 106HOOOOOX | Other | TX | LICENSED MARRIAGE & FAMILY THERAPIST, LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2914 (Texas) | Primary |
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