MEDICARE: MRS. HEATHER DRAGG GAGLIANO LCSW-BACS, ACSW

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	1041C0700X	Clinical Social Worker	7193	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7193	OTHER	LA	LCSW

General Provider Information

NPI Number	:	1376517219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER DRAGG GAGLIANO LCSW-BACS, ACSW

Provider Business Mailing Address
First Line	:	620 N MORRISON BLVD STE G
Second Line	:	LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS
City	:	HAMMOND
State	:	LA
Zip	:	70401-2312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 N MORRISON BLVD STE G
Second Line	:	LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS
City	:	HAMMOND
State	:	LA
Zip	:	70401-2312
Country	:	US
Telephone Number	:	985-543-4109
Fax Number	:

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	09/08/2014

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