Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ROBERT BRAGG, LAT
ActiveAddiction (Substance Use Disorder) Counselor · JACKSON, WY
Registration Details
- NPI Number
- 1225469661
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 11, 2013 (12.362346489812 yrs)
- Last Updated
- Dec 11, 2013
- License
-
LAT-202 (WY)
Practice Information
- Address
-
610 W BROADWAY AVE STE L1JACKSON, WY, 830018213Browse WY providers · Browse ZIP 83001
- Phone
- 3077333908
- Fax
- 3077340017
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in JACKSON, WY
| Name | Credential | NPI |
|---|---|---|
| MR. CURTIS E CRETAL | MAC | 1861625402 |
| TRUDYLYNN BIRKEMEYER FUNK | LCSW | 1649509084 |
| EDDIE RYAN | LCSW | 1629307558 |
| RYAN BURKE | LPC | 1265844815 |
| ANNE ELLINGSON | PROVISIONAL | 1841665668 |
| MS. CHERYL ANN RENZULLI | MA, LAT | 1093255242 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.