Provider Demographics
NPI:1174089346
Name:RAGLOW-DEFRANCO, CAROLYNE (LISW-R)
Entity type:Individual
Prefix:
First Name:CAROLYNE
Middle Name:
Last Name:RAGLOW-DEFRANCO
Suffix:
Gender:F
Credentials:LISW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5821
Mailing Address - Country:US
Mailing Address - Phone:716-783-3114
Mailing Address - Fax:
Practice Address - Street 1:6350 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5821
Practice Address - Country:US
Practice Address - Phone:716-783-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst