Provider Demographics
NPI:1275885956
Name:SUGLIA, REBECCA M (LSW)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:M
Last Name:SUGLIA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 POTTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:SHOEMAKERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19555-1721
Mailing Address - Country:US
Mailing Address - Phone:570-581-0216
Mailing Address - Fax:484-575-9213
Practice Address - Street 1:1383 POTTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:SHOEMAKERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19555-1721
Practice Address - Country:US
Practice Address - Phone:570-581-0216
Practice Address - Fax:484-575-9213
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-05
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128590104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker