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General NPI Number Information
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NPI Number | 1770065617
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Entity Type | Individual
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Provider Name | BIANCA INGRID GRAGG LCSW-A
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Gender | Female
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 1316 PATTON AVE STE D
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City | ASHEVILLE
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State | NC
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Zip | 28806-2652
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Country | US
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Telephone | 828-225-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 15 N BARCLAY DR
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City | CANDLER
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State | NC
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Zip | 28715-0179
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Country | US
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Telephone | 410-693-5504
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P012922
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License Number State | NC
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