Basic Information
| Provider Information | |||||||||
| NPI: | 1639474588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAGGY | ||||||||
| FirstName: | PARALEE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1390 PALESTINE ROAD | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 474217507 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122751200 | ||||||||
| FaxNumber: | 8122751231 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 W. 16TH STREET | ||||||||
| Address2: | |||||||||
| City: | BEDFORD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 474213510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122751200 | ||||||||
| FaxNumber: | 8122751328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2011 | ||||||||
| LastUpdateDate: | 01/24/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 34001170A | IN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.