Provider Demographics
NPI:1417540980
Name:TUGGLES, DEMONICA (LICSW)
Entity Type:Individual
Prefix:
First Name:DEMONICA
Middle Name:
Last Name:TUGGLES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14020 VISTA DR APT 49A
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6855
Mailing Address - Country:US
Mailing Address - Phone:917-484-0246
Mailing Address - Fax:
Practice Address - Street 1:14020 VISTA DR APT 49A
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-6855
Practice Address - Country:US
Practice Address - Phone:917-484-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC2000019021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical