Provider Demographics
NPI:1386424810
Name:DRAGGON, ANGIRA
Entity type:Individual
Prefix:MRS
First Name:ANGIRA
Middle Name:
Last Name:DRAGGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9629 HOLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-3153
Mailing Address - Country:US
Mailing Address - Phone:407-733-3927
Mailing Address - Fax:
Practice Address - Street 1:9629 HOLBROOK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-3153
Practice Address - Country:US
Practice Address - Phone:407-733-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24366101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health