Provider Demographics
NPI:1528394111
Name:DAGGETT, WILLARD M III (MED)
Entity Type:Individual
Prefix:MR
First Name:WILLARD
Middle Name:M
Last Name:DAGGETT
Suffix:III
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 GOODALE ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1011
Mailing Address - Country:US
Mailing Address - Phone:508-835-0901
Mailing Address - Fax:
Practice Address - Street 1:15 MONUMENT SQ STE 200
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-5711
Practice Address - Country:US
Practice Address - Phone:508-277-5158
Practice Address - Fax:508-267-0096
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor