Provider Demographics
NPI:1033478235
Name:DRAGO, CHERYL ANNE
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:DRAGO
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 1:1690 CROWN COLONY DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0913
Mailing Address - Country:US
Mailing Address - Phone:857-403-4600
Mailing Address - Fax:617-364-7363
Practice Address - Street 1:1690 CROWN COLONY DRIVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169
Practice Address - Country:US
Practice Address - Phone:857-403-4600
Practice Address - Fax:617-364-7363
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1102931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical