Provider Demographics
NPI:1063928703
Name:BRACCO, MARIA E (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:E
Last Name:BRACCO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2768
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77252-2768
Mailing Address - Country:US
Mailing Address - Phone:281-200-9120
Mailing Address - Fax:281-200-9765
Practice Address - Street 1:303 JACKSON HILL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7407
Practice Address - Country:US
Practice Address - Phone:281-200-9120
Practice Address - Fax:281-200-9765
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64049104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker