Provider Demographics
NPI:1720580509
Name:DAAGA, ISIS STEPHANIE (EDUCATION SPECIALIST)
Entity Type:Individual
Prefix:MRS
First Name:ISIS
Middle Name:STEPHANIE
Last Name:DAAGA
Suffix:
Gender:F
Credentials:EDUCATION SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9280 NW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7790
Mailing Address - Country:US
Mailing Address - Phone:678-895-7640
Mailing Address - Fax:
Practice Address - Street 1:9280 NW 55TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7790
Practice Address - Country:US
Practice Address - Phone:678-895-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health