Provider Demographics
NPI:1295025120
Name:DRYGAS, NOELLE D (MA)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:D
Last Name:DRYGAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 US 1 SOUTH
Mailing Address - Street 2:SUTIE C-2
Mailing Address - City:ST. AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-5786
Mailing Address - Country:US
Mailing Address - Phone:904-209-6001
Mailing Address - Fax:904-209-6002
Practice Address - Street 1:1955 US 1 SOUTH
Practice Address - Street 2:SUTIE C-2
Practice Address - City:ST. AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5786
Practice Address - Country:US
Practice Address - Phone:904-209-6001
Practice Address - Fax:904-209-6002
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor