Provider Demographics
NPI:1659643302
Name:OGANDO, AGUSTINA ALEXANDRA
Entity Type:Individual
Prefix:MRS
First Name:AGUSTINA
Middle Name:ALEXANDRA
Last Name:OGANDO
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 1:295 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-5439
Mailing Address - Country:US
Mailing Address - Phone:646-244-6526
Mailing Address - Fax:
Practice Address - Street 1:295 ORCHARD AVE
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-5439
Practice Address - Country:US
Practice Address - Phone:646-244-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical