MEDICARE: KIARRA' MECHEL'LA BRAGG LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	31349	MD

General Provider Information

NPI Number	:	1831939602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIARRA' MECHEL'LA BRAGG LMSW

Provider Business Mailing Address
First Line	:	12204 KINGSFORD CT
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-1950
Country	:	US
Telephone Number	:	240-505-2988
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 MERCANTILE LN STE 433
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-4321
Country	:	US
Telephone Number	:	240-681-9721
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2024
Last Update Date	:	05/29/2024

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Directions to “ KIARRA' MECHEL'LA BRAGG LMSW” Practice Location

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