Individual
SAMANTHA DAGENAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
330 FOUNTAIN ST, LAFAYETTE, IN 47901-1731
(765) 742-4848
(765) 477-9905
Mailing address
PO BOX 1186, LAFAYETTE, IN 47902-1186
(765) 742-4848
(765) 477-9905
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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