MEDICARE: MS. DONNA ROSE RAGUCCI LMHC

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	101YM0800X	Mental Health Counselor	MH6798	FL

General Provider Information

NPI Number	:	1932316726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DONNA ROSE RAGUCCI LMHC

Provider Business Mailing Address
First Line	:	1446 SPINDRIFT CIR E
Second Line	:
City	:	NEPTUNE BEACH
State	:	FL
Zip	:	32266-3226
Country	:	US
Telephone Number	:	904-219-4639
Fax Number	:

Provider Business Practice Location Address
First Line	:	1545 HUFFINGHAM RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-2721
Country	:	US
Telephone Number	:	904-725-6463
Fax Number	:

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

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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