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NPI Code Detail

MEDICARE: CARLY DRAGAN M.S., CCC-SLP

MEDICARE:   CARLY  DRAGAN  M.S., CCC-SLP
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
1103K00000XBehavior Analyst0133000649VA
2235Z00000XSpeech-Language Pathologist2202006666VA

General Provider Information

NPI Number : 1932540226
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY DRAGAN M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1701 BYRD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3011
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 BYRD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3011
Country : US
Telephone Number : 804-612-1947
Fax Number : 804-612-1955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2013
Last Update Date : 10/24/2024

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Directions to “ CARLY DRAGAN M.S., CCC-SLP” Practice Location

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