Provider Demographics
NPI:1306090964
Name:BRAGGS, SHELLIE A (BS)
Entity type:Individual
Prefix:MS
First Name:SHELLIE
Middle Name:A
Last Name:BRAGGS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 KING GEORGE DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-2215
Mailing Address - Country:US
Mailing Address - Phone:214-299-2934
Mailing Address - Fax:
Practice Address - Street 1:8625 KING GEORGE DR
Practice Address - Street 2:SUITE 111
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-2215
Practice Address - Country:US
Practice Address - Phone:214-299-2934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker