Doctor Name: | ANGELLA BRAMWELL |
NPI Number: | 1013255116 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | CSW002446 |
Business Practice Address: | 175 Gwinnett Dr Lawrenceville, GA - 300468444 |
Business Phone Number: | 7703392395 |
Business Fax Number: | 6789903997 |
Mailing Address: | 4202 Colony East Dr, STONE MOUNTAIN |
State: | GA |
Postal Code: | 300835414 |
Phone Number: | 4047179263 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2013 |
NPI Last Update Date: | 01/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CSW002446 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |