Provider Demographics
NPI:1326580234
Name:KLUGH, ALISSA MARIE
Entity Type:Individual
Prefix:MS
First Name:ALISSA
Middle Name:MARIE
Last Name:KLUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALISSA
Other - Middle Name:MARIE
Other - Last Name:ISAAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 CENTRAL CITY PLZ
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6441
Mailing Address - Country:US
Mailing Address - Phone:724-226-0600
Mailing Address - Fax:724-226-3287
Practice Address - Street 1:310 CENTRAL CITY PLZ
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6441
Practice Address - Country:US
Practice Address - Phone:724-226-0600
Practice Address - Fax:724-226-3287
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional