Provider Demographics
NPI:1578618096
Name:BRAGLIA, BONNIE LEE (LPC LMFT)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:LEE
Last Name:BRAGLIA
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6028 ENNIS JOSLIN AVE.
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-2806
Mailing Address - Country:US
Mailing Address - Phone:361-774-0293
Mailing Address - Fax:361-458-0029
Practice Address - Street 1:6028 ENNIS JOSLIN RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-2806
Practice Address - Country:US
Practice Address - Phone:361-774-0293
Practice Address - Fax:361-452-0029
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC09167101YP2500X
TX002914042697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional