Provider Demographics
NPI:1417517475
Name:TUGGLE, RICHARD Y SR
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:Y
Last Name:TUGGLE
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4604 BLUE ROCK CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-7676
Mailing Address - Country:US
Mailing Address - Phone:419-870-7425
Mailing Address - Fax:
Practice Address - Street 1:4604 BLUE ROCK CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-7676
Practice Address - Country:US
Practice Address - Phone:419-870-7425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH170683101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor