Provider Demographics
NPI:1003589292
Name:DARRAGH, ANASTASIA ALYSE
Entity Type:Individual
Prefix:MISS
First Name:ANASTASIA
Middle Name:ALYSE
Last Name:DARRAGH
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 1:1900 LITTLE RAVEN ST APT 318
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-7169
Mailing Address - Country:US
Mailing Address - Phone:248-982-2212
Mailing Address - Fax:
Practice Address - Street 1:2801 YOUNGFIELD ST STE 170
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-0210
Practice Address - Country:US
Practice Address - Phone:720-845-1976
Practice Address - Fax:720-845-1958
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0017806225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist