Provider Demographics
NPI:1467655373
Name:KUGLIN, NANCY JOYCE (MA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JOYCE
Last Name:KUGLIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9026 CHARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9474
Mailing Address - Country:US
Mailing Address - Phone:815-469-5979
Mailing Address - Fax:
Practice Address - Street 1:9026 CHARRINGTON DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9474
Practice Address - Country:US
Practice Address - Phone:815-469-5979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist