Provider Demographics
NPI:1225372212
Name:FRAGATA, SHIRLEY P
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:P
Last Name:FRAGATA
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 1:27 LUCYS PATH
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-6202
Mailing Address - Country:US
Mailing Address - Phone:508-224-2814
Mailing Address - Fax:
Practice Address - Street 1:603 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-1981
Practice Address - Country:US
Practice Address - Phone:781-821-1386
Practice Address - Fax:339-502-6712
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst