Provider Demographics
NPI:1053639237
Name:KUGLER, KATHY H (MS)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:H
Last Name:KUGLER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 SOUTH FT THOMAS AVE
Mailing Address - Street 2:
Mailing Address - City:FT THOMAS
Mailing Address - State:KY
Mailing Address - Zip Code:41075
Mailing Address - Country:US
Mailing Address - Phone:859-781-5586
Mailing Address - Fax:
Practice Address - Street 1:1201 SOUTH FT THOMAS AVE
Practice Address - Street 2:
Practice Address - City:FT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41075
Practice Address - Country:US
Practice Address - Phone:859-781-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-55103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY610661458OtherGROUP TAX ID NUMBER