Provider Demographics
NPI:1346864048
Name:BRAGAN, M. KATHERINE
Entity Type:Individual
Prefix:MRS
First Name:M.
Middle Name:KATHERINE
Last Name:BRAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 SANDY LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-8241
Mailing Address - Country:US
Mailing Address - Phone:401-441-8449
Mailing Address - Fax:
Practice Address - Street 1:659 SANDY LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-8241
Practice Address - Country:US
Practice Address - Phone:401-441-8449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health