Individual
CHARNA FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA COUNSELING
Contact information
Practice address
2400 S RIDGEWOOD AVE STE 32, SOUTH DAYTONA, FL 32119-3073
(863) 608-6427
Mailing address
PO BOX 12104, DAYTONA BEACH, FL 32120-2104
(863) 608-6427
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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