Provider Demographics
NPI:1033413208
Name:PUGLIA, BIANCA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:M
Last Name:PUGLIA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N 3RD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1499
Mailing Address - Country:US
Mailing Address - Phone:859-575-4100
Mailing Address - Fax:
Practice Address - Street 1:114 N 3RD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1499
Practice Address - Country:US
Practice Address - Phone:859-575-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2921101YP2500X
KY1223101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional