Healthcare Provider Details

I. General information

NPI: 1639474588
Provider Name (Legal Business Name): PARALEE DAGGY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2011
Last Update Date: 01/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W. 16TH STREET
BEDFORD IN
47421-3510
US

IV. Provider business mailing address

1390 PALESTINE ROAD
BEDFORD IN
47421-7507
US

V. Phone/Fax

Practice location:
  • Phone: 812-275-1200
  • Fax: 812-275-1328
Mailing address:
  • Phone: 812-275-1200
  • Fax: 812-275-1231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34001170A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: