Provider Demographics
NPI:1376517219
Name:GAGLIANO, HEATHER DRAGG (LCSW-BACS, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DRAGG
Last Name:GAGLIANO
Suffix:
Gender:F
Credentials:LCSW-BACS, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N MORRISON BLVD STE G
Mailing Address - Street 2:LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-2312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:620 N MORRISON BLVD STE G
Practice Address - Street 2:LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2312
Practice Address - Country:US
Practice Address - Phone:985-543-4109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7193OtherLCSW