Provider Demographics
NPI:1326576059
Name:BARRAGAN, ANDREA PATRICIA
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:PATRICIA
Last Name:BARRAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:PATRICIA
Other - Last Name:BARRAGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LMHC
Mailing Address - Street 1:8750 SW 132ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-5925
Mailing Address - Country:US
Mailing Address - Phone:786-385-9315
Mailing Address - Fax:
Practice Address - Street 1:8750 SW 132ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-5925
Practice Address - Country:US
Practice Address - Phone:786-385-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10186103T00000X
FL13532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist