Provider Demographics
NPI:1790854016
Name:DAGIRMANJIAN, JUDITH M (CSW-R)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:DAGIRMANJIAN
Suffix:
Gender:F
Credentials:CSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HARMATI LN
Mailing Address - Street 2:
Mailing Address - City:SHADY
Mailing Address - State:NY
Mailing Address - Zip Code:12409-5131
Mailing Address - Country:US
Mailing Address - Phone:845-679-5553
Mailing Address - Fax:
Practice Address - Street 1:307 WALL ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3893
Practice Address - Country:US
Practice Address - Phone:914-466-4309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056174-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical