Provider Demographics
NPI:1326831793
Name:BADGLEY, DARA
Entity type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:BADGLEY
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 1:309 WALMART DR LOT 17
Mailing Address - Street 2:
Mailing Address - City:SODDY DAISY
Mailing Address - State:TN
Mailing Address - Zip Code:37379-5029
Mailing Address - Country:US
Mailing Address - Phone:615-752-6196
Mailing Address - Fax:
Practice Address - Street 1:861 MANUFACTURERS RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5937
Practice Address - Country:US
Practice Address - Phone:423-775-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician