Most Relevant Information
Provider Data
NPI Number: | 1003555640 |
Provider Name: | BRANDY LUISSHA BAGGETT |
Entity Type: | Individual |
Taxonomy Code: | 101YM0800X |
Specialty: | Counselor |
License Number: |
Most Important Dates
Enumeration Date: | 06/01/2022 |
Last Updated: | 06/01/2022 |
Provider Practice Location
1620 SANTA CLARA DR STE 100
ROSEVILLE
CA
956613559
Practice Location Phone/Fax
Phone: | 9167863750 |
Fax: | 9167863761 |
Provider Mailing Location
1620 SANTA CLARA DR STE 100
ROSEVILLE
CA
956613559
Provider Mailing Phone/Fax
Phone: | 9167863750 |
Fax: | 9167863761 |