Provider Demographics
NPI:1356843650
Name:TUGGLE, BOBBI (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:
Last Name:TUGGLE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:
Other - Last Name:MUKUNDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:2100 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4319
Mailing Address - Country:US
Mailing Address - Phone:859-447-2309
Mailing Address - Fax:502-808-6024
Practice Address - Street 1:2100 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4319
Practice Address - Country:US
Practice Address - Phone:502-777-2397
Practice Address - Fax:502-808-6024
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267023103K00000X
KY240824106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1356843650OtherNPI