Provider Demographics
NPI:1649715087
Name:DUGUE-WRIGHT, DJA GABRIELLE
Entity type:Individual
Prefix:
First Name:DJA
Middle Name:GABRIELLE
Last Name:DUGUE-WRIGHT
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 1:10930 SW 244TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-4684
Mailing Address - Country:US
Mailing Address - Phone:786-261-3797
Mailing Address - Fax:
Practice Address - Street 1:10930 SW 244TH TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4684
Practice Address - Country:US
Practice Address - Phone:786-261-3797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist