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 |