STANLEY BRAGG

SANTA ROSA, CA
NPI1013368083
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  7744-r)
Enumeration Date2016-06-30
Last Update Date2016-06-30
Business Address
-- STANLEY BRAGG
6119 MONTECITO BLVD APT 12
SANTA ROSA, CA 95409-2969
Phone number: 707-888-2592
Mailing Address
-- STANLEY BRAGG
6119 MONTECITO BLVD APT 12
SANTA ROSA, CA 95409-2969
Phone number: 707-888-2592
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