Provider Demographics
NPI:1417578261
Name:PAGLIUGHI, KASSIE L
Entity Type:Individual
Prefix:
First Name:KASSIE
Middle Name:L
Last Name:PAGLIUGHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N ERIE ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4489
Mailing Address - Country:US
Mailing Address - Phone:989-778-1396
Mailing Address - Fax:
Practice Address - Street 1:1100 N. GRANT STREET
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708
Practice Address - Country:US
Practice Address - Phone:989-778-1396
Practice Address - Fax:989-778-1394
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)