Provider Demographics
NPI:1194998161
Name:BARRAGAN, MARIA D
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:BARRAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:D
Other - Last Name:BARRAGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:161 CRESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-4612
Mailing Address - Country:US
Mailing Address - Phone:708-856-4161
Mailing Address - Fax:
Practice Address - Street 1:161 CRESTVIEW LN
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-4612
Practice Address - Country:US
Practice Address - Phone:708-856-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter